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A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry

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Minerva Pediatrica 2010 February;62(1):29-41

language: Italian

Survival rates in a single neonatal intensive care unit (period 2002-2007). Neuro-developmental outcome and survival for infants born at 23-25 weeks of gestation

Bagnoli F. 1, Conte M. L. 1, Tomasini B. 1, Bellieni C. V. 1, Borlini G. 1, De Felice C. 1, Perrone S. 1, Zani S. 1, Gatti M. G. 2

1 Unità Operativa Complessa, Terapia Intensiva Neonatale, Dipartimento di Pediatria, Ostetricia e Medicina della Riproduzione,, Azienda Ospedaliera Universitaria Senese, Siena, Italia;
2 Unità Operativa Complessa di Pediatria Neonatale, Dipartimento di Pediatria, Ostetricia e Medicina della Riproduzione, Azienda Ospedaliera Universitaria Senese, Siena, Italia


AIM: The aim of this study was to evaluate survival rates in a single Neonatal Intensive Care Unit (NICU) (period 2002-2007), with a special focus on the survival data and outcome at one-year of corrected age for infants born at 23-25 weeks of gestation.
METHODS: All infants who had evidence of heart activity at birth were actively resuscitated, regardless of birth weight or gestational age. Survival rate was calculated as a function of the following variables: birth weight and gestational category; gender in infants of birth weight ≤1000 g ; appropriate (AGA) or small (SGA) weight for gestational age; inborn or outborn. Twenty-eight newborns (23-25 weeks of gestation) completed follow-up at one-year of corrected age.
RESULTS: During the examined period, no infants died in the delivery room; 833 newborns were admitted to the NICU. Overall survival rates were as following: <500 g (37%), 501-750 g (59%), 751-1000 g (82%), 1001-1250 g (96%), 1251-1500 g (97%), 1501-2000 g (100%), 2001-2500 g (98%), >2500 g (99%); 23-25 weeks of gestation (50%); 26-27 weeks (77%), 28-32 weeks (90%); males ≤1000 g (68%), females ≤1000 g (68%); AGA ≤1000 g (63%), SGA ≤1 000 g (79%), AGA ≤28 weeks (63%), SGA ≤28 weeks (67%); inborn (54%), outborn (25%). A fraction of 64% (infants of 23-25 weeks of gestation) did not show handicap at one-year of corrected age, while 25% presented severe, 7% moderate, and 4% mild handicaps.
CONCLUSION: High rate of survival without handicap at one-year of corrected age at extremely low gestational age and the chance of improvements in neonatal care for newborn ≤24 weeks, indicate the appropriateness for our strategy of resuscitating all newborns with evidence of heart activity in the delivery room.

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