title: Online Calculator to Improve Counseling of Short-Term Neonatal Morbidity and Mortality Outcomes at Extremely Low Gestational Age (23-28 Weeks).
abstract: Objective Extremely low gestational age (ELGA) infants are at high risk of perinatal and neonatal morbidity and mortality. Accurate and relevant data are essential for developing a health care plan and providing realistic estimates of infants' outcomes. Study Design Retrospective analysis of all infants delivered between 23(0/7) and 28(6/7) weeks' gestation over 11 years at a single center. Using logistic regression analysis, gestational age (GA)-specific mortality and morbidity rates, and the effects of gender, antenatal corticosteroids, multiple gestation, and birth weight (BW) were determined. Results Of the 766 study infants, 644 (84.1%) were admitted to the neonatal intensive care unit, of which 502 (75.8%) survived to discharge. GA, antenatal corticosteroids, and BW were significant predictors of survival (GA: odds ratio [OR] = 1.83, 95% confidence interval [CI] = 1.64-2.04; corticosteroids: OR = 7.62, 95% CI = 5.19-11.18; BW: OR = 1.56, 95% CI = 1.44-1.69). Increasing BW correlated with a decreasing mortality rate. Conclusion This study provides recent outcome data of ELGA infants delivered at a tertiary level center. The results have been translated into an online counseling tool (http://murmuring-brook-6600.herokuapp.com/ELGA.html).
authors.affiliation: Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Carol P
authors.initials: CP
authors.lastname: King
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Orlando
authors.initials: O
authors.lastname: da Silva
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Guido
authors.initials: G
authors.lastname: Filler
authors.affiliation: Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Laudelino M
authors.initials: LM
authors.lastname: Lopes
mesh_terms: D001724:Birth Weight; D003376:Counseling / Q000379:methods / Q000592:standards*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000209:etiology; D007363:Intensive Care Units, Neonatal; D020407:Internet; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009864:Ontario; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D062606:Tertiary Care Centers