In Norway, approximately half a percentage of all births happen before 27 weeks’ gestational age (GA). These extremely preterm infants have an increased risk of mortality and disabilities like cerebral palsy, sight and hearing impairment as well as learning and psychological difficulties.
The treatment of extremely preterm infants has changed since 2000, and the survival rate has improved in high income countries. In addition, the limits of offering life-saving treatment have changed.
This systematic review summarises studies of prognosis of extremely preterm children who have received life-saving treatment on survival and function until three years age.
We have summarised 52 studies, where 47 studies have estimated the prognosis of survival and 22 studies have estimated the risk of impairment in children born at 22-27 weeks of GA.
This systematic review shows that:
The prognosis of survival among live birth infants was 9% (95% Confidence interval (CI) 3-22)) for children born at 22 weeks of GA, and 55% (95% CI 39-70) for children born at 24 weeks of GA. The quality of evidence was moderate and low.
About two of three children born at 25-27 weeks of GA survived. These prognosis estimates were less heterogeneous than in week 22-24 GA.
The risk estimates of severe and less severe disabilities among children born at week 22-24 GA are very uncertain. The quality of evidence was low and very low.
Keywords: Extremely Premature; Prognosis; Follow‐up; Gestation; Survival; Mortality.
Copyright © 2017 by The Norwegian Institute of Public Health (NIPH).