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Does active treatment in infants born at 22–23 weeks correlate with outcomes of more mature infants at the same hospital? An analysis of California NICU data, 2015–2019

Journal of Perinatology volume 42, pages 1301–1305 (2022)Cite this article

Subjects

Abstract

Objective

To investigate whether hospital rates of active treatment for infants born at 22–23 weeks is associated with survival of infants born at 24–27 weeks.

Study design

We included all liveborn infants 22–27 weeks of gestation delivered at California Perinatal Quality Care Collaborative hospitals from 2015 to 2019. We assessed (1) the correlation of active treatment (e.g., endotracheal intubation, epinephrine) in 22–23 week infants and survival until discharge for 24–27 week infants and (2) the association of active treatment with survival using multilevel models.

Result

The 22–23 week active treatment rate was associated with infant outcomes at 22–23 weeks but not 24–27 weeks. A 10% increase in active treatment did not relate to 24–25 week (adjusted OR: 1.00 [95% CI: 0.95–1.05]), or 26–27 week survival (aOR: 1.02 [0.95–1.09]).

Conclusion

The hospital rate of active treatment for infants born at 22–23 weeks was not associated with improved survival for 24–27 week infants.

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Fig. 1: Cohort selection process, CPQCC 2015–2019.
Fig. 2: Comparison of hospital rates of 22-23 week infant active treatment and outcomes of interest by gestational age, CPQCC 2015–2019 (N = 88)a.

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Data availability

Data are available upon request and completion of requirements from CPQCC. Code is also available upon request.

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Funding

Research reported in this manuscript was supported by the National Institutes of Health under award number R01HD098287. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, 94306, USA

    Shalmali Bane

  2. Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, 77030, USA

    Matthew A. Rysavy

  3. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA

    Suzan L. Carmichael, Tianyao Lu, Mihoko Bennett & Henry C. Lee

  4. Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, 94306, USA

    Suzan L. Carmichael

  5. California Perinatal Quality Care Collaborative, Stanford, CA, 94306, USA

    Tianyao Lu, Mihoko Bennett & Henry C. Lee

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  1. Shalmali Bane
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  6. Henry C. Lee
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Contributions

SB and HCL conceived and designed this work and drafted the manuscript. SB conducted the study analysis with input from all other co-authors (HL, MAR, SLC, TL, MB). All authors provided critical feedback on study design and interpretation of results and approved the final version of the manuscript.

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Correspondence to Shalmali Bane.

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The authors declare no competing interests.

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Bane, S., Rysavy, M.A., Carmichael, S.L. et al. Does active treatment in infants born at 22–23 weeks correlate with outcomes of more mature infants at the same hospital? An analysis of California NICU data, 2015–2019. J Perinatol 42, 1301–1305 (2022). https://doi.org/10.1038/s41372-022-01381-x

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