Differences in hospital practices regarding the initiation of active treatment in infants born at 22, 23, or 24 weeks of gestation explain some of the between-hospital variation in survival and survival without impairment among such patients. Funded by the National Institutes of Health. The decision to initiate or forgo potentially lifesaving treatment in infants who are born near the limit of viability is extremely difficult.
In the United States, both the American Academy of Pediatrics AAP and the American Congress of Obstetricians and Gynecologists ACOG recommend that clinicians and families make individualized decisions about treating extremely preterm infants on the basis of parental preference and the most recent data available regarding survival and morbidity.
Counseling of families who are facing an extremely preterm birth is complicated by wide variation in outcomes. We studied infants who were born between April 1,and March 31,at 24 hospitals included in the NRN. The NRN consists of clinical centers of various sizes and in several U. We collected data for liveborn infants who were born before 27 weeks of gestation, including those who died in the delivery room. Data were collected for infants born before 22 weeks of gestation if they weighed g arab christian dating uk more; there was no minimum birth weight for infants born at or after 22 weeks of gestation.
A total of infants with recognized syndromes or major congenital malformations were excluded, because factors besides prematurity may have influenced the prognosis and treatment decisions for these infants.
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