Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada; Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada; Department of Pediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada.
J Pediatr. 2020 Oct;225:97-102.e3. doi: 10.1016/j.jpeds.2020.05.047. Epub 2020 May 28.
To provide comprehensive, contemporary information on the actuarial survival of infants born at 22-25 weeks of gestation in Canada.
In a retrospective cohort study, we included data from preterm infants of 22-25 weeks of gestation admitted to neonatal intensive care units participating in the Canadian Neonatal Network between 2010 and 2017. Infants with major congenital anomalies were excluded. We calculated gestational age using in vitro fertilization date, antenatal ultrasound dating, last menstrual period, obstetrical estimate, or neonatal estimate (in that order). Infants were followed until either discharge or death. Each day of gestational age was considered a category except for births at 22 weeks, where the first 4 days were grouped into one category and the last 3 days were grouped into another category. For each day of life, an actuarial survival rate was obtained by calculating how many infants survived to discharge out of those who had survived up to that day.
Of 4335 included infants, 85, 679, 1504, and 2067 were born at 22, 23, 24, and 25 weeks of gestation, respectively. Survival increased from 32% at 22 weeks to 83% at 25 weeks. Graphs of actuarial survival developed for the first 6 weeks after birth in male and female children indicated a steep increase in survival during the first 7-10 days postnatally.
Survival increased steadily with postnatal survival and was dependent on gestational age in days and sex of the child.
提供加拿大 22-25 孕周出生婴儿的保险统计生存情况的全面、现代信息。
在一项回顾性队列研究中，我们纳入了 2010 年至 2017 年期间参与加拿大新生儿网络的新生儿重症监护病房收治的 22-25 孕周早产儿的数据。排除了患有重大先天性畸形的婴儿。我们使用体外受精日期、产前超声日期、末次月经、产科估计或新生儿估计（按此顺序）计算胎龄。婴儿被随访至出院或死亡。除了 22 周出生的婴儿，将第 1 天至第 4 天归为一类，将第 5 天至第 7 天归为另一类，否则每个孕周都被视为一个类别。对于每一个生命日，通过计算截至该日幸存的婴儿中有多少幸存至出院，获得保险统计生存率。
在纳入的 4335 名婴儿中，分别有 85、679、1504 和 2067 名婴儿在 22、23、24 和 25 孕周出生。生存率从 22 孕周的 32%增加到 25 孕周的 83%。在男婴和女婴出生后前 6 周的保险统计生存情况图中，表明在出生后第 7-10 天，生存率急剧上升。
生存率随着产后生存而稳步提高，取决于胎龄天数和婴儿的性别。
