title: Influence of perinatal factors in short- and long-term outcomes of infants born at 23 weeks of gestation.
abstract: OBJECTIVE
  Investigate the influence of perinatal factors on short- and long-term outcomes for infants born at 23 weeks of gestation.
  
  
  METHODS
  This is a retrospective study over a 25-year period (1987-2011) of 87 successfully resuscitated infants at 23 weeks of gestation. We investigated the effects of poor prenatal care, race, gender, chorioamnionitis, antenatal corticosteroids, delivery route/location, low 5-minute Apgar score, birth weight, and multiple births on short- and long-term outcomes.
  
  
  RESULTS
  The mortality rate was 43% (37/87). A total of 88% (44/50) of the survivors were followed at 2 years corrected age with 66% (29/44) diagnosed with a moderate-to-severe neurological impairment. Outborn and multiple birth infants had significantly higher mortality (p-value 0.042 and 0.006, respectively). Lack of exposure to antenatal steroids and lower birth weight significantly increased the disability score (p-value 0.042 and 0.003, respectively).
  
  
  CONCLUSIONS
  Multiple perinatal factors significantly influence outcomes at the threshold of viability.
authors.affiliation: Division of Neonatal Medicine, Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois.
authors.forename: Hamzah R
authors.initials: HR
authors.lastname: Miltaha
authors.affiliation: Department of Pediatrics, New York Presbyterian-Weill Cornell Medical Center, New York, New York.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Fahey
authors.affiliation: Division of Neonatal Medicine, Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois.
authors.forename: Christine H
authors.initials: CH
authors.lastname: Sajous
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi.
authors.forename: John C
authors.initials: JC
authors.lastname: Morrison
authors.affiliation: Division of Neonatal Medicine, Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois.
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Muraskas
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000453:epidemiology; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011272:Pregnancy, Multiple; D047928:Premature Birth / Q000208:ethnology / Q000628:therapy*; D011295:Prenatal Care; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones