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Active Treatment and Shared Decision-making for Infants Born Extremely Preterm at 22 to 25 Weeks

Link [2022-08-17 08:21:04]

Active intervention for infants born preterm continues to increase at earlier gestational ages, including for infants only recently considered viable at 22 weeks. Survival rates at the lowest gestational ages also continue to increase, but data to support whether interventions improve neonatal outcomes or morbidities remain limited. Long-term neurodevelopmental impairment among infants born at the lowest gestational ages is common, and survival rates remain low, with a 2017 US report noting that survival in this population born at 22 to 24 weeks was 36% and survival without neurodevelopmental impairment was 20%. However, reports from centers in the US as well as other countries show variation in survival and morbidity rates, with some centers having significant improvements over time compared with others. Coupled with the often limited understanding by families of the sequelae of preterm birth, the lack of clarity about an individual infant’s risk for long-term disability creates barriers to effective counseling.