The Short‐term Outcome of Singleton Infants Delivered Before 28 Weeks' Gestation

EDITORIAL COMMENT: : This and the following paper present the survival rates and incidence of major impairment in infants who survive birth before 28 weeks' gestation in singleton and multiple pregnancies. Readers should consider the authors' careful words that period of gestation rather than estimation of birth‐weight is the parameter obstetricians should rely on when judging whether or not Caesarean section is indicated for a fetal indication; for singleton pregnancies the rubicon is 26 weeks' gestation. The authors consider that their findings lend further support for routine pregnancy ultrasound screening to confirm gestational age since the occurrence of problems in the second trimester can seldom be predicted. Summary: : The short‐term outcome of 271 singleton infants born at Westmead Hospital between 20 and 28 weeks' gestation, during a 5‐year period are reported. The earliest gestation at which there was a survivor was 23 weeks. Survival rates from 23‐23+6 weeks to 27‐27+6 weeks, excluding congenital abnormalities, were 8.3% to 77.5% respectively. Overall 21.9% of deaths occurred in the delivery suite, 63.4% in the neonatal period, 3.7% in the postneonatal period in hospital and a further 11% after discharge from hospital. Of survivors at 12 months, 18.8% were judged to have a major impairment.