Kono Yumi, Kusuda Satoshi, Nishida Toshihiko, Mori Rintaro, Toyoshima Katsuaki, Sasaki Hatoko, Yonemoto Naohiro, Uchiyama Atsushi, Fujimura Masanori
Jichi Medical University, Shimotsuke, Tochigi, Japan.
Neonatal Research Network of Japan, Shinjuku, Tokyo, Japan.
J Perinatol. 2025 Mar 26. doi: 10.1038/s41372-025-02268-3.
To evaluate neurodevelopmental outcomes of very preterm infants by gestational age (GA) using high follow-up rate data.
This secondary analysis included infants born before 32 weeks' gestation in 2012-2014 from the Improvement of NICU practices and Team Approach Cluster randomized controlled Trial (INTACT). The primary outcome was survival without moderate or severe neurodevelopmental impairment (NDI).
Among 2722 infants, NICU survival rate was 96.5%, ranging 72.1-99.6% at 22-31 weeks. At age three years, 2336 (89.5% of 2610 survivors) were completely assessed; 303 had moderate NDI and 183 had severe NDI. Of these, the proportions of infants surviving without NDI increased with GA; 45.2% at 22 weeks, 57.5% at 23 weeks, 88.1% at 31 weeks.
Although survival without NDI varied by GA, more than half (55.0%, 83/151) of infants born at 22-23 weeks who survived to age three years were without neurodevelopmental sequelae.
利用高随访率数据，按胎龄（GA）评估极早产儿的神经发育结局。
这项二次分析纳入了2012 - 2014年在新生儿重症监护病房（NICU）实践改善与团队协作整群随机对照试验（INTACT）中孕32周前出生的婴儿。主要结局是存活且无中度或重度神经发育障碍（NDI）。
在2722名婴儿中，NICU存活率为96.5%，在22 - 31周时为72.1% - 99.6%。在3岁时，对2336名（2610名存活者中的89.5%）进行了全面评估；303名有中度NDI，183名有重度NDI。其中，无NDI存活的婴儿比例随胎龄增加；22周时为45.2%，23周时为57.5%，31周时为88.1%。
尽管无NDI存活情况因胎龄而异，但在22 - 23周出生且存活至3岁的婴儿中，超过一半（55.0%，83/151）没有神经发育后遗症。
