SURVIVAL AND SHORT-TERM OUTCOME IN NEWBORNS OF 23 TO 25 WEEKS GESTATION

OBJECTIVES: We determined which factors are associated with survival a nd good short-term neurologic outcome in newborns of 23 to 25 weeks' g estation. STUDY DESIGN: We retrospectively reviewed the charts of all (n = 82) infants born alive at our hospital at 23 to 25 weeks' gestati on from 1988 through 1991. We used univariate and multiple logistic re gression analysis to compare survivors at hospital discharge with nons urvivors and those with and without good short-term neurologic outcome . RESULTS: Survival rates were 19%, 59%, and 65% at 23, 24, and 25 wee ks' gestation, respectively. A total of 90% of survivors had good shor t-term neurologic outcome. On multiple logistic regression analysis, f emale sex (odds ratio 8.7, 95% confidence limits 2.2 and 34), larger b irth weight (odds ratio 2.5 per 100 gm increment, 95% confidence limit s 1.3 and 4.9), and more advanced gestational age (odds ratio 5.3, 95% confidence limits 1.2 and 22 for 24 weeks; odds ratio 3.8, 95% confid ence limits 0.6 and 22 for 25 weeks) were associated with survival. Fe male sex, more advanced gestational age, and larger birth weight were also associated with good short-term neurologic outcome. CONCLUSIONS: Good short-term neurologic outcome is possible in many survivors in th is gestational age range. Factors other than gestational age may be co nsidered when intervention in these pregnancies is contemplated.