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PO-0429 2-year-outcome Of Surviving Preterm Infants (gestational Age 23–25 Weeks) In Switzerland: Impact Of The 2002/swiss Guidelines For The Care Of Infants Born At Limit Of Viability
  1. G Natalucci1,
  2. B Latal2,
  3. HU Bucher3,
  4. TM Berger4,
  5. M Adams3,5 for the Swiss Neonatal Network, Follow-Up Group
  1. 1Neonatology, University Hospital of Zurich, Zurich, Switzerland
  2. 2Developmental Center, University Childrens’ Hospital Zurich, Zurich, Switzerland
  3. 3Neonatology, University Hospital Zurich, Zurich, Switzerland
  4. 4Neonatal and Pediatric Intensive Care Unit, Children’s Hospital of Lucerne, Lucerne, Switzerland
  5. 5CH, Switzerland

Abstract

Background and aims In Switzerland, survival of extremely preterm infants (gestational age (GA) <26 weeks) improved following the publication of the 2002 Swiss Guidelines for the care of infants born at the limit of viability, and remained stable thereafter. We compared the 2-year-outcome of survivors of cohorts born before and after the publication of the Guidelines.

Methods 2-year-outcome of surviving preterm infants (GA 22–25 weeks) born in 2000–2001 (pre-Guideline), 2003–2004 (post-Guideline), and 2005–2009 (long-term) were compared. Neurodevelopment was assessed using the BSID-II or the Griffiths Mental Development Scales. Moderate neurodevelopmental impairment (NDI) was defined as development index of -3/-2SD from the norm, or mild cerebral palsy (GMFCS level 2); severe NDI as developmental index of <-3SD from the norm, cerebral palsy (GMFCS level ≥3), deafness or blindness.

Results Of 342 survivors, follow-up data was available for 294 (86%), 29 (8%) infants were lost to follow-up, and 19 (6%) datasets were not comparable. Normal development was observed in 48%, 47% and 54%, moderate NDI in 25, 30 and 26%, and severe NDI in 19%, 10% and 15% of the cases in the pre-Guideline cohort, the post-Guideline cohort and the long-term cohort, respectively. None of these differences over time were significant (χ2, p > 0.1).

Conclusion 2-year-outcome in survivors after extremely preterm birth remained stable despite improved survival rates following the publication of the Guidelines for the care of infants born at the limit of viability.

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