Department of Pediatrics, Children's Hospital of New Jersey, Newark, NJ, USA.
Joseph M. Sanzari Children's Hospital, HUMC, Hackensack, NJ, USA.
J Neonatal Perinatal Med. 2021;14(4):583-590. doi: 10.3233/NPM-200599.
Micro-premature newborns, gestational age (GA) ≤ 25 weeks, have high rates of mortality and morbidity. Literature has shown improving outcomes for extremely low gestational age newborns (ELGANs) GA ≤ 29 weeks, but few studies have addressed outcomes of ELGANs ≤ 25 weeks.
To evaluate the trends in outcomes for ELGANs born in New Jersey, from 2000 to 2018 and to compare two subgroups: GA 23 to 25 weeks (E1) and GA 26 to 29 weeks (E2).
Thirteen NICUs in NJ submitted de-identified data. Outcomes for mortality and morbidity were calculated.
Data from 12,707 infants represents the majority of ELGANs born in NJ from 2000 to 2018. There were 3,957 in the E1 group and 8,750 in the E2 group. Mortality decreased significantly in both groups; E1, 43.2% to 30.2% and E2, 7.6% to 4.5% over the 19 years. The decline in E1 was significantly greater than in E2. Most morbidities also showed significant improvement over time in both groups. Survival without morbidity increased from 14.5% to 30.7% in E1s and 47.2% to 69.9% in E2s. Similar findings held for 501-750 and 751-1000g birth weight strata.
Significant declines in both mortality and morbidity have occurred in ELGANs over the last two decades. These rates of improvements for the more immature ELGANs of GA 230 to 256 weeks were greater than for the more mature group in several outcomes. While the rates of morbidity and mortality remain high, these results validate current efforts to support the micro-premature newborn.
胎龄（GA）≤25 周的微型早产儿死亡率和发病率较高。文献表明，极早产儿（ELGANs）GA≤29 周的预后有所改善，但很少有研究涉及 GA≤25 周的 ELGANs 的结局。
评估 2000 年至 2018 年新泽西州 ELGAN 出生的趋势，并比较两个亚组：GA 23 至 25 周（E1）和 GA 26 至 29 周（E2）。
新泽西州的 13 家 NICU 提交了去识别数据。计算死亡率和发病率。
来自 2000 年至 2018 年新泽西州出生的 12707 名婴儿的数据代表了大多数 ELGAN。E1 组有 3957 例，E2 组有 8750 例。两组死亡率均显著下降；E1 组从 43.2%降至 30.2%，E2 组从 7.6%降至 4.5%。19 年来，E1 组的下降幅度明显大于 E2 组。随着时间的推移，两组的大多数发病率也显著改善。E1 组的无病生存率从 14.5%增加到 30.7%，E2 组从 47.2%增加到 69.9%。在 501-750 和 751-1000g 出生体重亚组中也有类似的发现。
在过去的二十年中，ELGAN 的死亡率和发病率都有显著下降。在几个结局中，GA 230 至 256 周的更不成熟的 ELGAN 组的这些改善率大于更成熟的组。尽管发病率和死亡率仍然很高，但这些结果验证了目前支持微型早产儿的努力。
