"Early" versus "late" 23-week infant outcomes

Objective: To determine whether survival is different in "early" (23^0/7-23^3/7 weeks) vs "late" (23 ^4/7-23^6/7 weeks) infants. Study Design: Records of 126 consecutive liveborn infants delivered at 23^0/7 to 23^6/7 weeks' gestation from 2001-2010 were examined using the Vermont Oxford Network database. Infants born at 23 0/7 to 23 3/7 weeks were grouped into "early" and those at 23 4/7 to 23 6/7 weeks were "late." Clinical characteristics were compared between groups and multivariate analyses were used to predict survival. Results: Seventy-two infants were early and 54 were late. Survival was 25% vs 56%, respectively (P <.001). The early group was less likely to receive steroids (43% vs 65%; P =.016) and had a lower mean birthweight (547 g vs 596 g; P <.001). No difference in other factors was seen between groups. No change in survival was observed during the study period in either group. Conclusion: Late 23-week infants have improved survival compared with early infants. Delaying delivery as little as 24-96 hours may improve survival for 23-week infants.