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Proactive neonatal treatment at 22 weeks of gestation: A systematic review and meta-analysis

American Journal of Obstetrics and Gynecology Sep 03, 2020

Backes CH, Rivera BK, Pavlek L, et al. - Via performing a systematic review and meta-analysis, researchers sought to quantify prognosis and determine factors linked with variations in documented mortality estimates among infants who were born at 22 weeks of gestation and provided proactive treatment (resuscitation and intensive care). Searching PubMed, Scopus, and Web of Science databases from January 2000 to February 2020, they identified 21,952 articles. Of these, 2,034 were considered in full; inclusion was performed of 31 studies involving 2,226 infants who were delivered at 22 weeks of gestation and provided proactive neonatal treatment. Infants born to mothers receiving antenatal corticosteroids had survival twice the survival of infants born to mothers not receiving antenatal corticosteroids. Employing a definition that includes any bronchopulmonary dysplasia, the overall prevalence of survival without major morbidity was 11.0%. The overall rate of survival of 37.0% was reported in cases with no moderate or severe impairment. Based on the year of publication, increase in survival rates was noted between 2000 and 2020. Interventions and outcomes reported highly varied among studies. Per these findings, the studies greatly varied in the reported survival rates; these rates were likely to be influenced by combining observational data from disparate sources, lack of individual patient–level data, and bias in the component studies from which the data were drawn. Hence, they emphasize interpreting the pooled results with caution. 

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