title: Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network.
abstract: OBJECTIVE
  This report presents data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network on care of and morbidity and mortality rates for very low birth weight infants, according to gestational age (GA).
  
  
  METHODS
  Perinatal/neonatal data were collected for 9575 infants of extremely low GA (22-28 weeks) and very low birth weight (401-1500 g) who were born at network centers between January 1, 2003, and December 31, 2007.
  
  
  RESULTS
  Rates of survival to discharge increased with increasing GA (6% at 22 weeks and 92% at 28 weeks); 1060 infants died at <or=12 hours, with most early deaths occurring at 22 and 23 weeks (85% and 43%, respectively). Rates of prenatal steroid use (13% and 53%, respectively), cesarean section (7% and 24%, respectively), and delivery room intubation (19% and 68%, respectively) increased markedly between 22 and 23 weeks. Infants at the lowest GAs were at greatest risk for morbidities. Overall, 93% had respiratory distress syndrome, 46% patent ductus arteriosus, 16% severe intraventricular hemorrhage, 11% necrotizing enterocolitis, and 36% late-onset sepsis. The new severity-based definition of bronchopulmonary dysplasia classified more infants as having bronchopulmonary dysplasia than did the traditional definition of supplemental oxygen use at 36 weeks (68%, compared with 42%). More than one-half of infants with extremely low GAs had undetermined retinopathy status at the time of discharge. Center differences in management and outcomes were identified.
  
  
  CONCLUSIONS
  Although the majority of infants with GAs of >or=24 weeks survive, high rates of morbidity among survivors continue to be observed.
authors: Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, 2015 Uppergate Dr, Atlanta, GA 30322, USA. barbara_stoll@oz.ped.emory.edu
authors: Barbara J
authors: BJ
authors: Stoll
authors: Nellie I
authors: NI
authors: Hansen
authors: Edward F
authors: EF
authors: Bell
authors: Seetha
authors: S
authors: Shankaran
authors: Abbot R
authors: AR
authors: Laptook
authors: Michele C
authors: MC
authors: Walsh
authors: Ellen C
authors: EC
authors: Hale
authors: Nancy S
authors: NS
authors: Newman
authors: Kurt
authors: K
authors: Schibler
authors: Waldemar A
authors: WA
authors: Carlo
authors: Kathleen A
authors: KA
authors: Kennedy
authors: Brenda B
authors: BB
authors: Poindexter
authors: Neil N
authors: NN
authors: Finer
authors: Richard A
authors: RA
authors: Ehrenkranz
authors: Shahnaz
authors: S
authors: Duara
authors: Pablo J
authors: PJ
authors: Sánchez
authors: T Michael
authors: TM
authors: O'Shea
authors: Ronald N
authors: RN
authors: Goldberg
authors: Krisa P
authors: KP
authors: Van Meurs
authors: Roger G
authors: RG
authors: Faix
authors: Dale L
authors: DL
authors: Phelps
authors: Ivan D
authors: ID
authors: Frantz
authors: Kristi L
authors: KL
authors: Watterberg
authors: Shampa
authors: S
authors: Saha
authors: Abhik
authors: A
authors: Das
authors: Rosemary D
authors: RD
authors: Higgins
mesh_terms: D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality* / Q000628:therapy; D008297:Male; D054582:National Institute of Child Health and Human Development (U.S.); D015996:Survival Rate; D014481:United States