Neonatal survival rates in 860 singleton live births at 24 and 25 weeks gestational age.

A Canadian multicentre study

Sidney B. Effer, Jean Marie Moutquin, Dan Farine, Saroj Saigal, Carl Nimrod, Edmond Kelly, Theophile Niyonsenga

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Objective: To determine the current survival rate of singleton living newborns born at gestational age of 24 and 25 weeks, using obstetric factors available to the physician before birth. Design: Retrospective study of all live births in 13 of 17 Canadian tertiary centres. Population: All singleton live births without congenital abnormalities. Methods: During the years 1991-1996, data were abstracted from clinical databases and charts of 860 live births, in 13 of the 17 tertiary centres in Canada, all with major neonatal intensive care units. Newborn survival was defined as alive at discharge from neonatal intensive care unit. Abstracted elements included gestational age, maternal antenatal corticosteroid treatment, birthweight, gender, fetal presentation and mode of delivery. Results: Average survival rates increased from 56.1% at 24 weeks (n = 406) to 68.0% at 25 weeks (n = 454). Survival rates ranged from 53.1% at day 168 to 81.6% at day 181 (r = 0.802, P < 0.05). Steroid administration improved the survival rates at 24 and 25 weeks compared with that of unexposed fetuses, respectively (58.9% vs 41.8%; OR 1.70; 95% CI 1.03-2.08 and 74.2% vs 56.8%; OR 2.19; 95% CI 1.41-3.38). Caesarean delivery for breech presentation improved survival compared with vaginal delivery, both at 24 and 25 weeks (56.1% vs 36.0%; OR 2.19; 95% CI 1.10-4.34, and 68.7% vs 55.2% OR 1.78; 95% CI 0.093-3.43). Female neonates displayed better survival rates (59.6% vs 52.1% OR 1.36; 95% CI 0.92-2.01, and 72.6% vs 63.1% OR 1.51; 95% CI 1.02-2.25) at 24 and 25 weeks, respectively. Explanatory regression model confirmed these factors as prognostic variables associated with survival. Conclusions: This extensive collaborative study confirms that several prognostic factors, known before birth, including gestational age in days, steroid treatment, mode of presentation and fetal sex may help obstetricians, neonatologists and parents in their decision-making process at 24 and 25 weeks of pregnancy.

Original languageEnglish
Pages (from-to)740-745
Number of pages6
JournalBJOG: an International Journal of Obstetrics and Gynaecology
Volume109
Issue number7
DOIs
Publication statusPublished - 2002
Externally publishedYes

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Live Birth
Gestational Age
Multicenter Studies
Survival Rate
Labor Presentation
Neonatal Intensive Care Units
Newborn Infant
Surrogate Mothers
Steroids
Parturition
Breech Presentation
Survival
Obstetrics
Canada
Decision Making
Adrenal Cortex Hormones
Fetus
Retrospective Studies
Parents
Databases

Cite this

Effer, Sidney B. ; Moutquin, Jean Marie ; Farine, Dan ; Saigal, Saroj ; Nimrod, Carl ; Kelly, Edmond ; Niyonsenga, Theophile. / Neonatal survival rates in 860 singleton live births at 24 and 25 weeks gestational age. A Canadian multicentre study. In: BJOG: an International Journal of Obstetrics and Gynaecology. 2002 ; Vol. 109, No. 7. pp. 740-745.
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Neonatal survival rates in 860 singleton live births at 24 and 25 weeks gestational age. A Canadian multicentre study. / Effer, Sidney B.; Moutquin, Jean Marie; Farine, Dan; Saigal, Saroj; Nimrod, Carl; Kelly, Edmond; Niyonsenga, Theophile.

In: BJOG: an International Journal of Obstetrics and Gynaecology, Vol. 109, No. 7, 2002, p. 740-745.

Research output: Contribution to journalArticle

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T1 - Neonatal survival rates in 860 singleton live births at 24 and 25 weeks gestational age.

T2 - A Canadian multicentre study

AU - Effer, Sidney B.

AU - Moutquin, Jean Marie

AU - Farine, Dan

AU - Saigal, Saroj

AU - Nimrod, Carl

AU - Kelly, Edmond

AU - Niyonsenga, Theophile

PY - 2002

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N2 - Objective: To determine the current survival rate of singleton living newborns born at gestational age of 24 and 25 weeks, using obstetric factors available to the physician before birth. Design: Retrospective study of all live births in 13 of 17 Canadian tertiary centres. Population: All singleton live births without congenital abnormalities. Methods: During the years 1991-1996, data were abstracted from clinical databases and charts of 860 live births, in 13 of the 17 tertiary centres in Canada, all with major neonatal intensive care units. Newborn survival was defined as alive at discharge from neonatal intensive care unit. Abstracted elements included gestational age, maternal antenatal corticosteroid treatment, birthweight, gender, fetal presentation and mode of delivery. Results: Average survival rates increased from 56.1% at 24 weeks (n = 406) to 68.0% at 25 weeks (n = 454). Survival rates ranged from 53.1% at day 168 to 81.6% at day 181 (r = 0.802, P < 0.05). Steroid administration improved the survival rates at 24 and 25 weeks compared with that of unexposed fetuses, respectively (58.9% vs 41.8%; OR 1.70; 95% CI 1.03-2.08 and 74.2% vs 56.8%; OR 2.19; 95% CI 1.41-3.38). Caesarean delivery for breech presentation improved survival compared with vaginal delivery, both at 24 and 25 weeks (56.1% vs 36.0%; OR 2.19; 95% CI 1.10-4.34, and 68.7% vs 55.2% OR 1.78; 95% CI 0.093-3.43). Female neonates displayed better survival rates (59.6% vs 52.1% OR 1.36; 95% CI 0.92-2.01, and 72.6% vs 63.1% OR 1.51; 95% CI 1.02-2.25) at 24 and 25 weeks, respectively. Explanatory regression model confirmed these factors as prognostic variables associated with survival. Conclusions: This extensive collaborative study confirms that several prognostic factors, known before birth, including gestational age in days, steroid treatment, mode of presentation and fetal sex may help obstetricians, neonatologists and parents in their decision-making process at 24 and 25 weeks of pregnancy.

AB - Objective: To determine the current survival rate of singleton living newborns born at gestational age of 24 and 25 weeks, using obstetric factors available to the physician before birth. Design: Retrospective study of all live births in 13 of 17 Canadian tertiary centres. Population: All singleton live births without congenital abnormalities. Methods: During the years 1991-1996, data were abstracted from clinical databases and charts of 860 live births, in 13 of the 17 tertiary centres in Canada, all with major neonatal intensive care units. Newborn survival was defined as alive at discharge from neonatal intensive care unit. Abstracted elements included gestational age, maternal antenatal corticosteroid treatment, birthweight, gender, fetal presentation and mode of delivery. Results: Average survival rates increased from 56.1% at 24 weeks (n = 406) to 68.0% at 25 weeks (n = 454). Survival rates ranged from 53.1% at day 168 to 81.6% at day 181 (r = 0.802, P < 0.05). Steroid administration improved the survival rates at 24 and 25 weeks compared with that of unexposed fetuses, respectively (58.9% vs 41.8%; OR 1.70; 95% CI 1.03-2.08 and 74.2% vs 56.8%; OR 2.19; 95% CI 1.41-3.38). Caesarean delivery for breech presentation improved survival compared with vaginal delivery, both at 24 and 25 weeks (56.1% vs 36.0%; OR 2.19; 95% CI 1.10-4.34, and 68.7% vs 55.2% OR 1.78; 95% CI 0.093-3.43). Female neonates displayed better survival rates (59.6% vs 52.1% OR 1.36; 95% CI 0.92-2.01, and 72.6% vs 63.1% OR 1.51; 95% CI 1.02-2.25) at 24 and 25 weeks, respectively. Explanatory regression model confirmed these factors as prognostic variables associated with survival. Conclusions: This extensive collaborative study confirms that several prognostic factors, known before birth, including gestational age in days, steroid treatment, mode of presentation and fetal sex may help obstetricians, neonatologists and parents in their decision-making process at 24 and 25 weeks of pregnancy.

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