%0 Journal Article %1 Doyle1994 %A Doyle, L. W. %A Permezel, M. %A Ford, G. W. %A Knoches, A. M. %A Rickards, A. L. %A Kelly, E. A. %A Callanan, C. %D 1994 %J Aust N Z J Obstet Gynaecol %K Cerebral Palsy; Child Development; Child, Preschool; Disability Evaluation; Female; Follow-Up Studies; Gestational Age; Humans; Infant; Infant, Newborn; Premature; Nervous System Diseases; Pregnancy; Survival Rate; Time Factors; Wechsler Scales %N 4 %P 421--424 %T The obstetrician and the extremely immature fetus (24-26 weeks): outcome to 5 years of age. %V 34 %X The aims of this study were to determine the outcome to 5 years of age for fetuses 24-26 weeks of gestational age from the obstetric viewpoint, and to determine if their outcome has improved over time. Consecutive fetuses with gestational ages from 24-26 weeks born at the Royal Women's Hospital, Melbourne, during 2 separate eras, Era 1 (1977-1982; n = 198) and Era 2 (1985-1987; n = 128) were studied and their outcome to 5 years of age determined. Fetuses referred with lethal malformations or clearly dead before the onset of labour were excluded. The stillbirth rates were similar in both eras (Era 1 23.7\%, Era 2 21.9\%), but the proportion of survivors to 5 years of age was much higher in Era 2 (Era 1 19.7\%, Era 2 30.5\%, X2 = 5.0, p < 0.03; odds ratio 1.80; 95\% confidence interval CI 1.07 to 3.04). Overall, both the proportion and the absolute number of severely disabled children fell over time; 4 children survived with severe sensorineural disability in the 5 1/4 years of Era 1, but only one child in the 3 years of Era 2. From the obstetric viewpoint, only 1.5\% of total births survived with a severe sensorineural disability, no higher than the rate expected for children born at term. Fetuses born at 24-26 weeks of gestational age need not contribute disproportionately to the number of severely disabled children in the community; furthermore, their outcome is improving over time. From the obstetrician's viewpoint, survival chances rather than sensorineural outcome should dominate decision-making at these extremely preterm gestations.

@article{Doyle1994, abstract = {The aims of this study were to determine the outcome to 5 years of age for fetuses 24-26 weeks of gestational age from the obstetric viewpoint, and to determine if their outcome has improved over time. Consecutive fetuses with gestational ages from 24-26 weeks born at the Royal Women's Hospital, Melbourne, during 2 separate eras, Era 1 (1977-1982; n = 198) and Era 2 (1985-1987; n = 128) were studied and their outcome to 5 years of age determined. Fetuses referred with lethal malformations or clearly dead before the onset of labour were excluded. The stillbirth rates were similar in both eras (Era 1 23.7\%, Era 2 21.9\%), but the proportion of survivors to 5 years of age was much higher in Era 2 (Era 1 19.7\%, Era 2 30.5\%, X2 = 5.0, p < 0.03; odds ratio 1.80; 95\% confidence interval [CI] 1.07 to 3.04). Overall, both the proportion and the absolute number of severely disabled children fell over time; 4 children survived with severe sensorineural disability in the 5 1/4 years of Era 1, but only one child in the 3 years of Era 2. From the obstetric viewpoint, only 1.5\% of total births survived with a severe sensorineural disability, no higher than the rate expected for children born at term. Fetuses born at 24-26 weeks of gestational age need not contribute disproportionately to the number of severely disabled children in the community; furthermore, their outcome is improving over time. From the obstetrician's viewpoint, survival chances rather than sensorineural outcome should dominate decision-making at these extremely preterm gestations.}, added-at = {2014-07-19T19:23:23.000+0200}, author = {Doyle, L. W. and Permezel, M. and Ford, G. W. and Knoches, A. M. and Rickards, A. L. and Kelly, E. A. and Callanan, C.}, biburl = {https://www.bibsonomy.org/bibtex/26f55aeb71babb02166b151fbf0104f50/ar0berts}, groups = {public}, interhash = {107d49d31c516826d82e42fedbc412d5}, intrahash = {6f55aeb71babb02166b151fbf0104f50}, journal = {Aust N Z J Obstet Gynaecol}, keywords = {Cerebral Palsy; Child Development; Child, Preschool; Disability Evaluation; Female; Follow-Up Studies; Gestational Age; Humans; Infant; Infant, Newborn; Premature; Nervous System Diseases; Pregnancy; Survival Rate; Time Factors; Wechsler Scales}, month = Aug, number = 4, pages = {421--424}, pmid = {7848231}, timestamp = {2014-07-19T19:23:23.000+0200}, title = {The obstetrician and the extremely immature fetus (24-26 weeks): outcome to 5 years of age.}, username = {ar0berts}, volume = 34, year = 1994 }