Background and aims Decisions in pregnancies at the limit of viability are usually taken primarily based on gestational age. Other factors, however, may be critical to the results. The aim of our study was to know which perinatal factors are associated with survival in neonates ≤ 26 weeks GA.
Methods Retrospective analysis of prospectively collected data. We included all inborn infants ≤ 26 weeks GA without major congenital malformations, admitted to the NICUs participating in the Spanish SEN1500 network, during the period 2004–2010. The relation of risk factors to the likelihood of survival was analysed with the Cox Proportional-Hazards Regression method.
Results During the study period 3,915 infants ≤ 26 weeks GA were born alive. Of these, 3,518 (89,9%) were “inborns”. Infants who died in the delivery room and/or who had severe congenital malformations were excluded. Finally, 3,236 patients were included. After correcting for potential confounders, survival was related to the following antenatal and postnatal variables:
Conclusions GA, birth weight, female sex, antenatal steroid and single gestation are factors potentially known prenatally that are associate with a higher probability of survival. After birth, in the first 12 h after admission, the CRIB I score and the temperature at admission were independently associated with differences in survival.