SURVIVAL AND FOLLOW-UP OF INFANTS BORN AT 23 TO 26 WEEKS OF GESTATIONAL-AGE - EFFECTS OF SURFACTANT THERAPY

Little information is available regarding the effect of surfactant on outcome for infants born at or before 26 weeks of gestation. We addres sed this issue by reviewing records of 310 infants born at gestational ages of 23 through 26 weeks who were admitted to our nursery from 198 6, when surfactant was introduced, through 1990. Surfactant was admini stered to 154 infants (5 during a single-dose prevention study, 25 dur ing a multiple-dose prevention study, 124 while receiving a Food and D rug Administration treatment investigational new drug); 156 infants we re not treated with surfactant. Seventy-three percent of the treated i nfants survived, compared with 55% of the nontreated infants. Increase d survival occurred at all gestational ages between 23 and 26 weeks bu t were greatest in infants born at 23 and 24 weeks. At follow-up, no d ifferences in neurologic outcome were detected between surfactant-trea ted and nontreated infants. We conclude that surfactant use in extreme ly premature infants improves survival rates without increasing the pr oportion of impaired survivors.