Higgins Brennan V, Baer Rebecca J, Steurer Martina A, Karvonen Kayla L, Oltman Scott P, Jelliffe-Pawlowski Laura L, Rogers Elizabeth E
Division of Neonatology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, USA.
J Perinatol. 2024 Feb;44(2):209-216. doi: 10.1038/s41372-023-01774-6. Epub 2023 Sep 9.
To describe changes over time in resuscitation, survival, and morbidity of extremely preterm infants in California.
This population-based, retrospective cohort study includes infants born ≤28 weeks. Linked birth certificates and hospital discharge records were used to evaluate active resuscitation, survival, and morbidity across two epochs (2011-2014, 2015-2019).
Of liveborn infants, 0.6% were born ≤28 weeks. Active resuscitation increased from 16.9% of 22-week infants to 98.1% of 25-week infants and increased over time in 22-, 23-, and 25-week infants (p-value ≤ 0.01). Among resuscitated infants, survival to discharge increased from 33.2% at 22 weeks to 96.1% at 28 weeks. Survival without major morbidity improved over time for 28-week infants (p-value < 0.01).
Among infants ≤28 weeks, resuscitation and survival increased with gestational age and morbidity decreased. Over time, active resuscitation of periviable infants and morbidity-free survival of 28-week infants increased. These trends may inform counseling around extremely preterm birth.
描述加利福尼亚州极早产儿复苏、生存及发病情况随时间的变化。
这项基于人群的回顾性队列研究纳入了孕周≤28周的婴儿。利用关联的出生证明和医院出院记录评估两个时期（2011 - 2014年、2015 - 2019年）的积极复苏、生存及发病情况。
活产婴儿中，0.6%为孕周≤28周。积极复苏率从22周婴儿的16.9%增至25周婴儿的98.1%，且在22周、23周和25周婴儿中随时间增加（p值≤0.01）。在接受复苏的婴儿中，出院存活率从22周时的33.2%增至28周时的96.1%。28周婴儿无严重发病的存活率随时间提高（p值<0.01）。
在孕周≤28周的婴儿中，复苏和存活率随孕周增加而上升，发病率下降。随着时间推移，可存活边缘期婴儿的积极复苏及28周婴儿无发病存活情况增加。这些趋势可为极早产相关咨询提供参考。
