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Encouraging outcomes for Sweden’s extremely preterm babies

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2799 (Published 01 May 2013) Cite this as: BMJ 2013;346:f2799

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Among 707 extremely preterm babies born alive in Sweden between 2004 and 2007, 491 (69%) survived to a corrected age of 2.5 years. They had significantly more disabilities than matched babies born at term in a national cohort study. However, nearly three quarters (73%) of survivors reached 2.5 years with only mild disability (31%) or no disability at all (42%).

All babies in the preterm cohort were born before 27 completed weeks of gestation. One in five survivors had moderate or severe developmental delay, the dominant disability. Thirty two (7%) had cerebral palsy—13 mild, 13 moderate, and six severe. Blindness and deafness both had a prevalence of less than 1%.

Better survival rates for extremely preterm babies need not mean worse disability, say the authors, who believe their results are achievable with universal access to free, proactive, and technically advanced perinatal care.

The odds of moderate or severe disability fell by roughly half with each extra week of gestational age in this study (odds ratio 0.55, 99% CI 0.39 to 0.79 for moderate disability and 0.58, 0.39 to 0.86 for severe disability). There are few times in life when a single week can make such a difference, says a linked editorial (p 1834).

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Cite this as: BMJ 2013;346:f2799