How Young Is Too Young for Intensive Care?

Outcomes of very premature infants who received intensive care were predicted better by the combination of gestational age, sex, use of antenatal steroids, singleton birth, and birth weight than by gestational age alone.

One of the most difficult clinical decisions is whether to initiate intensive care for extremely premature infants. Although this decision generally is made by neonatologists, the basis for decisions must be clear. Currently, the most important determinants are gestational age and parental wishes, but ascertainment of gestational age is not an exact science. To examine other factors that predict outcome in extremely premature infants, researchers prospectively studied a large cohort of infants born at 22 to 25 weeks’ gestation.

Of 4446 infants born in 19 U.S. centers, 3702 received intensive care (in the form of mechanical ventilation). Infants who received intensive care had a mean gestational age of 24.2 weeks and a mean birth weight of 67…

Reviewing Author

William P. Kanto, Jr.,, MD