Survival and Neurodevelopmental Outcomes in Extremely Low Gestational Age Newborns
Author Information
Author(s): Washburn Lisa K, Dillard Robert G, Goldstein Donald J, Klinepeter Kurt L, deRegnier Raye-Ann, O'Shea Thomas Michael
Primary Institution: Wake Forest University School of Medicine
Hypothesis
Are survival rates and major neurodevelopmental impairments in extremely low gestational age newborns changing over time?
Conclusion
Survival rates increased while major neurodevelopmental impairments decreased in extremely low gestational age newborns during the 1990s.
Supporting Evidence
- Survival of ELGANs increased from 67% in epoch 1 to 71% in epoch 2.
- Major neurodevelopmental impairment decreased from 20% in epoch 1 to 14% in epoch 2.
- Odds ratio for survival increased to 1.5 when adjusted for gestational age.
- Odds ratio for major neurodevelopmental impairment decreased to 0.54 when adjusted for gestational age.
Takeaway
This study found that more babies born very early are surviving, and fewer of them have serious developmental problems as they grow up.
Methodology
The study reviewed records of infants born at 23-27 weeks gestation without congenital anomalies and compared outcomes across two time periods.
Potential Biases
Potential biases include the use of different editions of developmental assessment tools and expectation bias in identifying neurological abnormalities.
Limitations
The study is limited by its geographic focus and the lack of data on certain prenatal factors.
Participant Demographics
Infants born at 23-27 weeks gestation in a thirteen-county region in North Carolina.
Statistical Information
P-Value
p = .03
Confidence Interval
(61, 72) for epoch 1 and (65, 75) for epoch 2 regarding survival rates.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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