Survival of Infants in the NICU Who Were Born Between Weeks 22 and 25 of Pregnancy

The study was aimed to gather contemporary data on infants born at 22 to 25 weeks of gestation who received care in level 3 and 4 neonatal intensive care units (NICUs) across the developed country.

Data was obtained from infants born between 2020 and 2022 at hospitals with level 3 or 4 NICUs, focusing on survival to hospital discharge as the primary outcome. Secondary outcomes included survival without severe complications, length of hospital stay, and technology dependence.

The results demonstrated the following:

• A total of 22,953 infants from 636 hospitals were included.
• The use of postnatal life support increased from 68.0% at 22 weeks to 99.8% at 25 weeks. 
• Survival rates varied remarkably, with 24.9% at 22 weeks and 82.0% at 25 weeks. 
• Survival rates among those receiving postnatal support were 35.4% at 22 weeks and 82.0% at 25 weeks.
• Survival without severe complications increased from 6.3% at 22 weeks to 43.2% at 25 weeks. 
• The median length of stay decreased from 160 days for 22-week-olds to 110 days for 25-week-olds. 
• Survivors born at 22 weeks had higher rates of technology dependence at discharge compared to those born at later gestational ages.

Thus, the study concluded that survival rates for infants born at 22 to 25 weeks gestation are poor, with significant challenges correlated to severe complications, lengthy hospital stays, and high technology dependence among survivors.

Source: Edwards EM, Ehret DEY, Soll RF, Horbar JD. Survival of Infants Born at 22 to 25 Weeks' Gestation Receiving Care in the NICU: 2020-2022. Pediatrics. 2024 Oct 1;154(4):e2024065963. doi: 10.1542/peds.2024-065963. PMID: 39323403.