title: [Morbidity and mortality in newborns at the limit of viability in Spain: a population-based study].
abstract: BACKGROUND
  Perinatal care in extremely immature newborns is a clinical and ethical problem of great importance for professionals and families, and requires that the available information on the chances of child survival is of the highest quality. The aim of this study was to determine the specific rates of survival at hospital discharge, and survival without major morbidity in newborns with a gestation age (GA) ≤ 26 weeks in Spain.
  
  
  METHODS
  We included live newborns ≤ 26 weeks admitted to the collaborating centers of the SEN1500 network (2004-2010). Out born patients, infants who died in delivery room, and those with congenital anomalies incompatible with life were excluded.
  
  
  RESULTS
  A total of 3,236 patients were included. GA specific survival was 12.5, 13.1, 36.9, 55.7, and 71.9% at 22, 23, 24, 25, and 26 weeks of GA, respectively. Survival without severe intracranial hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, and/or retinopathy of prematurity was 1.5, 9.5, 19.0, and 29.9% at 23, 24, 25 and 26 weeks GA, respectively.
  
  
  CONCLUSIONS
  Survival without major morbidity in infants less than 23 weeks GA is exceptional, and scarce in newborns with 23 and 24 weeks GA. Infants ≥ 25 weeks GA have reasonable chances of survival and, in the absence of major malformations or other relevant complications, should be offered active resuscitation and intensive care. The continuous updating of the results of individual centers is of utmost importance, as well as their comparison with the reference population-based results.
authors.affiliation: Servicio de Neonatología, Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España. Electronic address: fgarciamu@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: García-Muñoz Rodrigo
authors.affiliation: Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: García-Alix Pérez
authors.affiliation: Servicio de Ginecología y Obstetricia, Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
authors.forename: J A
authors.initials: JA
authors.lastname: García Hernández
authors.affiliation: Hospital Clínic, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Figueras Aloy
mesh_terms: D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality*; D008297:Male; D013030:Spain; D015996:Survival Rate
keywords: Clinical decision-making; Extreme prematurity; Lesión cerebral mayor; Limits of viability; Límites de viabilidad; Major brain damage; Morbidity; Morbilidad; Mortalidad; Mortality; Prematuridad extrema; Toma de decisiones clínicas
vernacular_title: Morbimortalidad en recién nacidos al límite de la viabilidad en España: estudio de base poblacional.