Vermont Oxford Network, Burlington, Vermont.
Department of Pediatrics, Robert Larner, MD, College of Medicine, University of Vermont, Burlington, Vermont.
Pediatrics. 2024 Oct 1;154(4). doi: 10.1542/peds.2024-065963.
To provide contemporary data on infants inborn at 22 to 25 weeks' gestation and receiving care at level 3 and 4 neonatal intensive care units in the United States.
Vermont Oxford Network members submitted data on infants born at 22 to 25 weeks' gestation at a hospital with a level 3 or 4 NICU from 2020 to 2022. The primary outcome was survival to hospital discharge. Secondary outcomes included survival without severe complications, length of stay, and technology dependence.
Overall, 22 953 infants at 636 US hospitals were included. Postnatal life support increased from 68.0% at 22 weeks to 99.8% at 25 weeks. The proportion of infants born at 22 weeks receiving postnatal life support increased from 61.6% in 2020 to 73.7% in 2022. For all infants, survival ranged from 24.9% at 22 weeks to 82.0% at 25 weeks. Among infants receiving postnatal life support, survival ranged from 35.4% at 22 weeks to 82.0% at 25 weeks. Survival without severe complications ranged from 6.3% at 22 weeks to 43.2% at 25 weeks. Median length of stay ranged from 160 days at 22 weeks to 110 days at 25 weeks. Among survivors, infants born at 22 weeks had higher rates of technology dependence at discharge home than infants born at later gestational ages.
Survival ranged from 24.9% at 22 weeks to 82.1% at 25 weeks, with low proportions of infants surviving without complications, prolonged lengths of hospital stay, and frequent technology dependence at all gestational ages.
提供美国 3 级和 4 级新生儿重症监护病房收治的 22 至 25 孕周出生婴儿的当代数据。
2020 年至 2022 年，美国佛蒙特州牛津网络成员向设有 3 级或 4 级新生儿重症监护病房的医院提交了 22 至 25 孕周出生婴儿的数据。主要结局为出院时存活。次要结局包括无严重并发症存活、住院时间和技术依赖。
共有 636 家美国医院的 22953 名婴儿纳入研究。出生后生命支持从 22 周的 68.0%增加到 25 周的 99.8%。22 周出生接受出生后生命支持的婴儿比例从 2020 年的 61.6%增加到 2022 年的 73.7%。所有婴儿的存活率从 22 周的 24.9%到 25 周的 82.0%不等。在接受出生后生命支持的婴儿中，存活率从 22 周的 35.4%到 25 周的 82.0%不等。无严重并发症存活率从 22 周的 6.3%到 25 周的 43.2%不等。中位住院时间从 22 周的 160 天到 25 周的 110 天不等。幸存者中，22 周出生的婴儿出院时依赖技术的比例高于较晚孕周出生的婴儿。
存活率从 22 周的 24.9%到 25 周的 82.1%不等，所有胎龄的婴儿中，无并发症存活、住院时间延长和频繁依赖技术的比例都较低。
