title: [Survival and neurologic outcomes after extremely preterm birth].
abstract: OBJECTIVE
  To determine survival and neurologic outcomes at 2 years after extremely preterm birth.
  
  
  METHODS
  A retrospective study including all births (live births and stillbirths) and late terminations of pregnancy at 22-26 completed weeks' gestation in the Pays de la Loire region of France in 2004-2005. We determined survival rates, factors associated with death in neonatal intensive care units (NICUs), and neurologic assessment at the corrected age of 2 years by the Loire Infant Follow-up Team (LIFT).
  
  
  RESULTS
  A total of 444 births were recorded, 37% were medical terminations of pregnancy, 34% were stillbirths, and 29% were live births. Among the 129 hospitalized live births, the survival rate at discharge was 47% (13.7% of all obstetrical outcomes). Mortality decreased with gestational age (P=0.02) and cesarean section (P=0.03). Mortality was higher after extrauterine transport (OR=4.44; 95% CI [1.63-12.12]; P<0.01) and in cases of grade III or IV intraventricular hemorrhage (OR=13.7; 95% CI [4.85-38.5]; P<0.01). The NICU where infants were admitted, gender, multiple birth, and birth weight did not alter mortality. At the corrected age of 2years, 26% of survivors had a normal neurologic assessment, whereas 31% had severe abnormal neurologic outcome.
  
  
  CONCLUSIONS
  In our study, survival and neurologic outcomes of extremely preterm infants were poor. An extended neurologic follow-up seems necessary for these children, in order to diagnose and manage any subsequent disability.
authors.affiliation: Service de réanimation néonatale, CHU de Nantes, 38 boulevard Jean-Monnet, Nantes cedex 1, France. gerald.boussicault@chu-nantes.fr
authors.forename: G
authors.initials: G
authors.lastname: Boussicault
authors.forename: B
authors.initials: B
authors.lastname: Branger
authors.forename: C
authors.initials: C
authors.lastname: Savagner
authors.forename: J-C
authors.initials: JC
authors.lastname: Rozé
mesh_terms: D001724:Birth Weight; D001925:Brain Damage, Chronic / Q000401:mortality*; D002423:Cause of Death; D002585:Cesarean Section; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France; D005865:Gestational Age; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality*; D007363:Intensive Care Units, Neonatal; D008297:Male; D009460:Neurologic Examination; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D015996:Survival Rate