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Ismail_Clinical outcomes at 27-31 weeks_JNN 2022.pdf (1.32 MB)

Clinical outcomes for babies born between 27 – 31 weeks of gestation: Should they be regarded as a single cohort?

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posted on 2022-08-31, 15:16 authored by Abdul Qader Tahir Ismail, Elaine M. Boyle, Thillagavathie Pillay, Neena Modi, Oliver Rivero-Arias, Bradley Manktelow, Sarah E. Seaton, Natalie Armstrong, Miaoqing Yang, Abdul Qader T. Ismail, Sila Bountziouka, Caroline S. Cupit, Alexis Paton, Victor L. Banda, Elizabeth S. Draper, Kelvin Dawson
Preterm babies born between 27 and 31 weeks of gestation are understudied and historically, have been grouped as a single cohort. Increased evidence relating to clinical outcomes is shaping models of care for babies born ≤26 weeks of gestation. Similar consideration of births between 27 and 31 weeks of gestation is now warranted. To address this, a clear understanding of the impact of progressive maturation in utero on the clinical care required, and on neonatal and infant outcomes of this group of preterm babies is helpful. In this review we highlight the spectrum of clinical presentations for babies born at 27–31 weeks of gestation. We discuss this with respect to key stages of organ/system development occurring in-utero during this five-week period and reveal a consistent trend of decreasing incidence of mortality and major morbidity with increasing gestational age at birth from 27 to 31 weeks. The clinical care required and the outcomes between babies born at either end of this gestational age range appear to be substantially different. This suggests it may be more appropriate to report outcomes by week of gestation rather than as a group in future research. Preterm health service delivery providers and decision makers need to consider this in planning services for the future, especially in environments where neonatal intensive care resources ought to be optimised for those at greatest need.

Funding

This work is supported by the National Institute for Health Research, Health Services and Delivery Research Stream, Project number 15/70/ 104, and Royal Wolverhampton NHS Trust, Protocol number 2016NEO87.

History

Citation

Journal of Neonatal Nursing, 2022 in press

Author affiliation

Department of Health Sciences

Version

  • VoR (Version of Record)

Published in

Journal of Neonatal Nursing

Publisher

Elsevier

issn

1355-1841

Acceptance date

2022-04-12

Copyright date

2022

Available date

2022-08-31

Language

en

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