The EPICure Study: Outcomes to Discharge From Hospital for Infants Born at the Threshold of Viability

摘要: Objective. To evaluate the outcome for all infants born before 26 weeks of gestation in United Kingdom and Republic Ireland. This report is survival complications up until discharge from hospital. Methodology. A prospective observational study births between March 1, 1995 December 31, 20 to 25 gestation. Results. total 4004 were recorded, 811 admitted intensive care. Overall was 39% (n 5 314). Male sex, no reported chorioamnio- nitis, antenatal steroids, persistent bradycardia at minutes, hypothermia, high Clinical Risk Index Babies (CRIB) score independently associated with death. Of survivors, 17% had parenchymal cysts and/or hydrocephalus, 14% received treatment reti- nopathy prematurity (ROP), 51% needed supple- mentary oxygen expected date delivery. Failure administer steroids postnatal transfer care within 24 hours birth predic- tive major scan abnormality; lower pre- dictive severe ROP, while being a black mother protective. Being gestation, male tocolysis, low maternal age, neonatal CRIB score, surfactant therapy dependency. Intensive provided 137 units, only 8 which >5 survivors. There difference institutions when di- vided into quintiles based on their numbers extremely preterm or admissions. Conclusions. provides data this geographically defined cohort; morbidity are consistent previous facilitate comparison other data. Pediatrics 2000;106:659 - 671; ex- tremely infant, survival, cerebral ultrasound scan, intraventricular hemorrhage, cysts, hydro- cephalus, retinopathy prematurity, chronic lung disease. ABBREVIATIONS. PMA, postmenstrual age; NNU, unit; LMP, last menstrual period; EDD, delivery; prematurity; CI, confidence interval; HR, heart rate; CRIB, Babies; RDS, respiratory distress syndrome; IQR, interquartile range; PROM, prolonged rupture membranes .24 hours; Fio2, fraction inspired oxygen; PDA, patent ductus arteriosus. T he fetus considered be threshold viability raises some most difficult clinical problems obstetricians pediatricians. Advice given parents needs reliable contemporary information drawn appropriate populations. The number these an individual unit small con- clusions unreliable. Pub- lished reports derive range populations including those single tertiary centers se- lected patients others areas. Furthermore, differently different studies show wide variation. For example, since 1990, gestational published rates 35% 79% 1,2 disability 12% 35%. 3,4 EPICure designed describe sur- vival health completed age In article we progress during initial admission