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Actuarial Survival Based on Gestational Age in Days at Birth for Infants Born at <26 Weeks of Gestation.

Authors
  • Shah, Prakesh S1
  • Rau, Sanaya2
  • Yoon, Eugene W2
  • Alvaro, Ruben3
  • da Silva, Orlando4
  • Makary, Hala5
  • Claveau, Martine6
  • Lee, Shoo K7
  • 1 Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada; Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada; Department of Pediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. Electronic address: [email protected] , (Canada)
  • 2 Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada. , (Canada)
  • 3 Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba (or MB?), Canada. , (Canada)
  • 4 Departments of Pediatrics, London Health Sciences Centre and Western University, London, ON, Canada. , (Canada)
  • 5 Department of Pediatrics, Dr. Everett Chalmers Hospital, Fredericton, New Brunswick, Canada. , (Canada)
  • 6 Department of Pediatrics, Montreal Children's Hospital at McGill University Health Centre, Montréal, Quebec, Canada. , (Canada)
  • 7 Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada; Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada; Departments of Pediatrics and Obstetrics and Gynecology and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. , (Canada)
Type
Published Article
Journal
The Journal of pediatrics
Publication Date
Oct 01, 2020
Volume
225
Identifiers
DOI: 10.1016/j.jpeds.2020.05.047
PMID: 32474028
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To provide comprehensive, contemporary information on the actuarial survival of infants born at 22-25 weeks of gestation in Canada. In a retrospective cohort study, we included data from preterm infants of 22-25 weeks of gestation admitted to neonatal intensive care units participating in the Canadian Neonatal Network between 2010 and 2017. Infants with major congenital anomalies were excluded. We calculated gestational age using in vitro fertilization date, antenatal ultrasound dating, last menstrual period, obstetrical estimate, or neonatal estimate (in that order). Infants were followed until either discharge or death. Each day of gestational age was considered a category except for births at 22 weeks, where the first 4 days were grouped into one category and the last 3 days were grouped into another category. For each day of life, an actuarial survival rate was obtained by calculating how many infants survived to discharge out of those who had survived up to that day. Of 4335 included infants, 85, 679, 1504, and 2067 were born at 22, 23, 24, and 25 weeks of gestation, respectively. Survival increased from 32% at 22 weeks to 83% at 254-6/7 weeks. Graphs of actuarial survival developed for the first 6 weeks after birth in male and female children indicated a steep increase in survival during the first 7-10 days postnatally. Survival increased steadily with postnatal survival and was dependent on gestational age in days and sex of the child. Copyright © 2020 Elsevier Inc. All rights reserved.

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