LeMoine Felicia V, Battarbee Ashley N, Travers Colm P, Battersby Cheryl, Gibson Kelly S
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston, Houston, US.
Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
J Perinatol. 2025 Apr 11. doi: 10.1038/s41372-025-02289-y.
Preterm birth between 22 and 25 5/7 weeks complicates <1% of live births within the United States though contributes more than 20% of infant mortality within the first year of life. Ante- and intrapartum interventions such as antenatal corticosteroids, magnesium sulfate, and tocolytic and antibiotic therapies have been shown effective in optimizing postnatal prognosis in births at 24 weeks and beyond. Interventions, mode of delivery, and resuscitation plans should ideally be discussed with the perinatology, neonatology, and nursing teams with the family using shared decision making. Observational data have alluded to similar postnatal benefits in births at 22-23 weeks; however, these data are limited by small sample sizes, inconsistencies in outcome reporting, and variations in management strategies. Future studies to evaluate the utility of these interventions among births at 22-23 weeks are warranted.
在美国，孕22至25⁵/₇周的早产占活产的比例不到1%，但其导致的婴儿在出生后第一年内的死亡率却超过20%。产前和产时干预措施，如产前使用糖皮质激素、硫酸镁、宫缩抑制剂和抗生素治疗，已被证明对改善孕24周及以后出生婴儿的产后预后有效。理想情况下，应与围产医学、新生儿学和护理团队以及家庭共同参与决策，讨论干预措施、分娩方式和复苏计划。观察性数据显示，孕22至23周出生的婴儿也有类似的产后益处；然而，这些数据存在样本量小、结果报告不一致以及管理策略差异等局限性。有必要开展进一步研究，以评估这些干预措施在孕22至23周出生婴儿中的效用。
