Objective To determine survival and outcomes in infants born at 22–24 weeks of gestation in a centre with a uniformly active approach to management of extremely preterm infants. Study design Single-centre retrospective cohort study including infants born 2006–2015. Short-term morbidities assessed included retinopathy of prematurity, necrotising enterocolitis, patent ductus arteriosus, intraventricular haemorrhage, periventricular malacia and bronchopulmonary dysplasia. Neurodevelopmental outcomes assessed included cerebral palsy, visual impairment, hearing impairment and developmental delay. Results Total survival was 64% (143/222), ranging from 52% at 22 weeks to 70% at 24 weeks. Of 133 (93%) children available for follow-up at 2.5 years corrected age, 34% had neurodevelopmental impairment with 11% classified as moderately to severely impaired. Treatment-requiring retinopathy of prematurity, severe bronchopulmonary dysplasia, visual impairment and developmental delay correlated with lower gestational age. Conclusions A uniformly active approach to all extremely preterm infants results in survival rates that are not distinctly different across the gestational ages of 22–24 weeks and more than 50% survival even in infants at 22 weeks. The majority were unimpaired at 2.5 years, suggesting that such an approach does not result in higher rates of long-term adverse neurological outcome. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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对妊娠 22-24 周出生的婴儿采取统一积极方法的结果

目的 确定在采用统一积极方法管理极早产儿的中心中出生 22-24 周的婴儿的存活率和结局。研究设计 单中心回顾性队列研究，包括 2006-2015 年出生的婴儿。评估的短期发病率包括早产儿视网膜病变、坏死性小肠结肠炎、动脉导管未闭、脑室内出血、脑室周围软化和支气管肺发育不良。评估的神经发育结果包括脑瘫、视力障碍、听力障碍和发育迟缓。结果 总生存率为 64% (143/222)，范围从 22 周时的 52% 到 24 周时的 70%。在 2.5 岁矫正年龄可进行随访的 133 名 (93%) 儿童中，34% 患有神经发育障碍，11% 被归类为中度至重度障碍。需要治疗的早产儿视网膜病变、严重的支气管肺发育不良、视力障碍和发育迟缓与较低的胎龄相关。结论 对所有极早产儿采取统一积极的方法导致 22-24 周胎龄的存活率没有明显差异，即使在 22 周的婴儿中存活率也超过 50%。大多数人在 2.5 年时未受损，这表明这种方法不会导致更高的长期不良神经学结果发生率。与研究相关的所有数据都包含在文章中或作为补充信息上传。结论 对所有极早产儿采取统一积极的方法导致 22-24 周胎龄的存活率没有明显差异，即使在 22 周的婴儿中存活率也超过 50%。大多数人在 2.5 年时未受损，这表明这种方法不会导致更高的长期不良神经学结果发生率。与研究相关的所有数据都包含在文章中或作为补充信息上传。结论 对所有极早产儿采取统一积极的方法导致 22-24 周胎龄的存活率没有明显差异，即使在 22 周的婴儿中存活率也超过 50%。大多数人在 2.5 年时未受损，这表明这种方法不会导致更高的长期不良神经学结果发生率。与研究相关的所有数据都包含在文章中或作为补充信息上传。