Department of Pediatrics, Toyohashi Municipal Hospital, Aichi, Japan.
Neonatology. 2011;100(3):228-32. doi: 10.1159/000324715. Epub 2011 Jun 22.
Increased survival rates for extremely low birth weight infants have been reported. However, survival rates and prognoses of extremely preterm infants, such as infants born at 22 weeks of gestation, are still poor.
To investigate such infants' long-term outcomes, developmental assessments were performed.
Seven infants with gestational age of 22 weeks were delivered in our hospital from 2005 to 2008. One infant was a stillbirth despite resuscitation in the delivery room. Six infants, 4 boys and 2 girls, with a gestational age of 22 weeks (range 22(3/7)-22(6/7) weeks), were admitted to the neonatal intensive care unit (NICU). Birth weights ranged from 514 to 710 g. None of the infants suffered from sepsis, necrotizing enterocolitis, or severe intraventricular hemorrhage.
The survival rate was 85.7% (6/7) as a percentage of deliveries and 100% (6/6) as a percentage of NICU admissions. None of the infants suffered from deafness, blindness, cerebral palsy, or epilepsy. Six infants were available for developmental assessments at 18 months' corrected age. Three infants showed normal developmental quotients, and 3 infants showed developmental delay.
In our study, all infants admitted to the NICU at a gestational age of 22 weeks were discharged from the hospital alive. This might suggest that infants after 22 weeks' gestation be considered eligible for active treatment in Japan, though considering the size of the material, generalizibility of the results cannot be considered guaranteed.
极低出生体重儿的存活率有所提高。然而，极早产儿（如 22 周出生的婴儿）的存活率和预后仍然较差。
为了研究这些婴儿的长期预后，对其进行了发育评估。
2005 年至 2008 年，我院收治了 7 例孕龄为 22 周的婴儿。其中 1 例在产房复苏后仍为死产。6 例婴儿（4 男 2 女），孕龄为 22 周（22（3/7）-22（6/7）周），均入住新生儿重症监护病房（NICU）。出生体重为 514-710g。所有婴儿均未发生败血症、坏死性小肠结肠炎或严重脑室出血。
存活率为分娩时的 85.7%（6/7），NICU 入住时的 100%（6/6）。所有婴儿均未出现耳聋、失明、脑瘫或癫痫。6 例婴儿在 18 个月校正年龄时进行了发育评估。3 例婴儿发育商正常，3 例婴儿发育迟缓。
在我们的研究中，所有在 22 周孕龄时入住 NICU 的婴儿均存活出院。这表明在日本，22 周以上的胎儿可以考虑进行积极治疗，但考虑到样本量，结果的推广性不能保证。
