To investigate the effect of pregestational maternal, obstetric and perinatal factors on neonatal outcome in extreme preterm deliveries.
Retrospective study of deliveries in a Norwegian tertiary teaching hospital. All women with live births at 24(+0)- 27(+6) weeks of gestation between 2004 and 2007 were included. Major morbidity is defined as intraventricular haemorrhage grade 3-4, periventricular leukomalacia, bronchopulmonary dysplasia or necrotizing enterocolitis. Pregestational maternal, obstetric and perinatal variables were initially compared for mortality and survival with major morbidity at 24-h, 7- or 28-day postpartum/discharge in univariate analysis. Then, a multivariate analysis was conducted in order to determine independent factors associated with mortality and survival with major morbidity.
A total of 109 babies were delivered alive in 92 women, representing 1.6% of total births. The survival rates were 93.6, 84.4 and 80.7%, with a prevalence of major morbidity among survivors of 40.4, 32.1 and 39.4% at 24-h, 7- and 30-day postpartum/discharge, respectively. After adjustment using multiple logistic regression, only a 5-min Apgar score = 3 and babies with at least one major morbidity had significantly independent effects on neonatal survival. Multiple pregnancy and gestational age
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Cites: Best Pract Res Clin Obstet Gynaecol. 2007 Oct;21(5):869-8217531538