Characterization of mothers at risk of delivery at the limit of viability and factors related to infant survival.
OBJECTIVE
To determine the sociodemographic and clinical characteristics of mothers of infants at the limit of viability and to know the perinatal factors associated to infants' survival.


METHODS
Single-center cohort study of mothers and newborns assisted in our tertiary care center (2004-2010). Demographic and perinatal variables were compared between mothers who gave birth  ≤26 weeks GA and the general population. The association between perinatal factors and neonatal survival was studied by Cox regression analysis.


RESULTS
Mothers of newborns  ≤26 weeks (n = 136) had less education and pregnancy control. They had more frequently assisted reproductive technologies (ART) (5.2% versus 2.3%; p< 0.05), multiple gestations (16.6% versus 2.1%; p < 0.05), pregnancy complications and C-section (39.7% versus 13.4%; p  < 0.001). After correcting for confounders, the perinatal factors independently associated with a variation in the risk of mortality were the administration of antenatal steroid [aHR (95%CI): 0.465 (0.254-0.853), p = 0.013], singleton pregnancy [aHR (95%CI): 0.482 (0.279-0.834), p = 0.009], infant's temperature on admission [aHR (95%CI): 0.642 (0.426-0.968), p = 0.035] and CRIB score [aHR (95%CI): 1.151 (1.058-1.251), p  = 0.001].


CONCLUSIONS
Mothers of preterm infants at the limit of viability had more ART, multiple pregnancies, obstetrical complications and C-section. Infants' survival was independently associated to antenatal steroids, singleton pregnancy, temperature on admission and CRIB score.
a Neonatal Unit, Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria , Spain.
Fermín
F
García-Muñoz Rodrigo
b Obstetric and Gynecology Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas, de Gran Canaria , Spain , and.
José Ángel
JÁ
García Hernández
c Neonatal Unit, Hospital Sant Joan de Deu , Barcelona , Spain.
Alfredo
A
García-Alix
D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
Extremely preterm newborn; cesarean section; limits of viability; risk factors; survival