Determinants of survival in extremely preterm infants born at 22-23 weeks: a retrospective cohort study.

BACKGROUND

This study investigated the risk factors associated with mortality in infants born at 22-23 weeks and assessed the impact of different variables on survival outcomes.

METHODS

This retrospective study included 185 infants born at 22-23 weeks at a single tertiary care center (2006-2023). Univariate and logistic regression analyses identified independent predictors of mortality.

RESULTS

Among 185 infants, 64 (34.6%) did not survive. Mortality was associated with a lower birth weight (509 g vs. 564 g, p = 0.0001) and higher rates of small for gestational age (SGA; 21.9% vs. 7.4%, p = 0.009). Independent predictors included SGA [odds ratio (OR): 5.8], tension pneumothorax (OR: 9.9), severe intraventricular hemorrhage (OR: 3.3), focal intestinal perforation (OR: 4.1), necrotizing enterocolitis (OR: 18.9), and early-onset sepsis (OR: 9.7). Cesarean delivery was associated with reduced mortality (OR: 0.3).

CONCLUSIONS

Targeted management of these risk factors and cesarean delivery may improve the outcomes in this population.