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Extreme prematurity (<28 weeks' gestation) is a major contributor to neonatal mortality in the U.S. and continues to create a burden of long-term respiratory and neurodevelopmental morbidity.
Investigators from the Neonatal Research Network examined trends over time in maternal and neonatal care practices and neonatal outcomes, analyzing data from 34,636 extremely preterm infants (gestational age, 22 weeks 0 days through 28 weeks 6 days) born at 26 network hospitals between 1993 and 2012. Results were as follows:
Changes in practice included increased use of antenatal steroids (24% to 87%), increased cesarean delivery (44% to 64%), decreased delivery room intubation (80% to 65%), and decreased use of postnatal steroids (29% to 13%).
Survival t…