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Hospital practice explains variation in outcomes in extremely premature infants, US study finds

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h2524 (Published 08 May 2015) Cite this as: BMJ 2015;350:h2524
  1. Michael McCarthy
  1. 1 Seattle

Much of the variation seen in outcomes among infants born at 22, 23, or 24 weeks of gestation can be explained by differences in hospitals’ practices on whether to initiate active treatment to save the lives of these extremely premature newborns, concludes a new study in the New England Journal of Medicine.1

The study found that hospitals at which active treatment was more often started had higher rates of risk-adjusted survival, both with and without impairment, than hospitals at which active treatment was less often started.

Currently, active intervention, such as the administration of surfactant therapy, intubation, ventilatory support, resuscitation, and parenteral support, is generally not recommended for infants born before 22 weeks of gestation. But for infants born at or after 22 weeks practice varies from institution to institution, and the American Academy of Pediatrics and the American Congress of Obstetricians and …

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