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With Medical Care, 70 Percent of Preterm Infants Survive

Study finds 45 percent of infants born before 27 weeks had no major morbidities at one year

TUESDAY, June 2 (HealthDay News) -- Seventy percent of extremely preterm infants born in Sweden survive to their first birthdays, most of them with the help of medical intervention, according to a report in the June 3 issue of the Journal of the American Medical Association.

Mats Blennow, M.D., of Karolinska University Hospital in Huddinge, Sweden, and colleagues conducted a study of 707 severely preterm infants (gestational age of less than 27 weeks) born in Swedish obstetric units between 2004 and 2007. The primary outcomes were survival to 365 days and survival without major morbidity, such as retinopathy, intraventricular hemorrhage, necrotizing enterocolitis, periventricular leukomalacia, and bronchopulmonary dysplasia. The researchers also analyzed associations between medical interventions and survival.

Of the preterm infants, the researchers found that 91 percent were admitted to neonatal intensive care, with 70 percent surviving to 1 year of age. Survival increased with gestational age, ranging from 9.8 percent at 22 weeks to 85 percent at 26 weeks. Medical factors that lowered risk of infant death were birth at a level III hospital (odds ratio, 0.49), surfactant treatment within two hours of birth (odds ratio, 0.47), antenatal corticosteroids (odds ratio, 0.44), and tocolytic treatment (odds ratio, 0.43). Forty-five percent of the infants who survived a year had no major neonatal morbidity, the authors note.

"Proactive perinatal management is likely to have contributed to this outcome. Therefore, noninitiation or withdrawal of intensive care for extremely preterm infants cannot be based solely on a notion of unlikely survival," Blennow and colleagues conclude.

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