ArticleBMJ paediatrics open2018
Changes in survival and neurodevelopmental outcomes of infants born at <25 weeks' gestation: a retrospective observational study in tertiary centres in Japan.
Article in BMJ paediatrics open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Swiss Recommendations for the Perinatal Care of Extremely Low Gestational Age Neonates.Acta paediatrica (Oslo, Norway : 1992) · 2026Guideline
- Pooled it
- Associations of socioeconomic status and nurturing environment with developmental outcomes in very preterm children without sensorimotor impairment: a secondary analysis of the INTACT study.European journal of pediatrics · 2026Trial
- Cluster-randomized evaluation of neonatal intensive care unit quality improvement interventions in extremely preterm infants: secondary analysis of the INTACT trial.BMC pediatrics · 2026Trial
- Neurodevelopmental outcomes at age 3 years of preterm infants born at 22-31 weeks' gestation.Journal of perinatology : official journal of the California Perinatal Association · 2025Trial
- Japan at the limits of viability: national experience and evolving outcomes of infants born at 22-23 weeks' gestation.Pediatric research · 2026Review
- Outcomes at 21 weeks' gestation: a case series with neurodevelopmental follow-up.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Mortality and morbidity in very preterm infants in Switzerland spanning 16 years (2006-2021).BMJ paediatrics open · 2026Article
- Morbidity, Mortality, and Short-Term Outcomes of Preterm Infants ≤ 25 Weeks of Gestation.Journal of clinical medicine · 2026Article
- From "can we treat?" to "should we treat?": a narrative review on resuscitation limits at the threshold of viability.European journal of pediatrics · 2026Review
- Artificial Womb Technology for Extremely Premature Neonates: Preclinical Neurodevelopmental Outcomes.Children (Basel, Switzerland) · 2025Review
- Outcomes of Infants Born at 21 Weeks' Gestational Age.JAMA network open · 2025Article
- Association between early-phase opioid use and outcomes in extremely preterm infants: A nationwide study.Pediatric research · 2025Article
- Outcomes of Preterm Infants Born at 22 to 23 Weeks' Gestation in 11 International Neonatal Networks.JAMA pediatrics · 2025Article
- Determinants of survival in extremely preterm infants born at 22-23 weeks: a retrospective cohort study.Frontiers in pediatrics · 2025Article
- Respiratory support and bronchopulmonary dysplasia in infants born at 22-26 weeks gestation in Sweden, 2004-2007 and 2014-2016.The European respiratory journal · 2025Article
- Sex differences in the association of pretransfusion haemoglobin and cognition in preterm infants.BMJ paediatrics open · 2024Observational
- Descriptive and Functional Genomics in Neonatal Respiratory Distress Syndrome: From Lung Development to Targeted Therapies.International journal of molecular sciences · 2024Review
- Management and outcomes of periviable neonates born at 22 weeks of gestation: a single-center experience in Japan.Journal of perinatology : official journal of the California Perinatal Association · 2023Observational
- Outcomes of congenital diaphragmatic hernia among preterm infants: inverse probability of treatment weighting analysis.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate changes in the outcomes of infants born at <25 weeks' gestation in the past decade.
designRetrospective observational study. SETTINGS: A multicentre database of the Neonatal Research Network, Japan. PATIENTS: A total of 3318 infants born at 22-24 weeks' gestation between periods 1 (2003-2007) and 2 (2008-2012) from 52 tertiary centres.
main outcome measuresWe compared death and neurodevelopmental impairments (NDIs) at 3 years of age, including cerebral palsy (CP), visual impairments (VIs), hearing impairments (HIs) and the developmental quotient (DQ) of the Kyoto Scale of Psychological Development test <70, between two periods using multivariate logistic regression analyses adjusted for the centre, gender, multiple gestation, maternal age, caesarean delivery, antenatal steroid use, pregnancy-related hypertension, clinical chorioamnionitis, congenital anomalies and birth weight.
resultsA total of 496/1479 infants (34%) in period 1 and 467/1839 (25%) in period 2 died by 3 years of age (adjusted OR 0.70, 95% CIs 0.59 to 0.83). Follow-up data were collected from 631 infants (64% of survivors) in period 1 and 832 (61% of survivors) in period 2. The proportions of CP with Gross Motor Function Classification System ≥2, VI and HI in the infants evaluated were lower, while that of DQ <70 was higher in period 2 than in period 1. Using multiple imputations to account for missing data, death or NDI decreased from 54% in period 1 to 47% in period 2 (0.83, 0.71 to 0.97). Significant decreases were observed in death or CP (0.65, 0.55 to 0.76), death or VI (0.59, 0.50 to 0.69) and death or HI (0.69, 0.58 to 0.81), but not in death or DQ <70 (0.91, 0.78 to 1.06).
conclusionAlong with improved survival, CP, VI and HI, but not cognitive impairments decreased in infants born at <25 weeks' gestation between the two periods examined in the last decade. Further strategies are needed to reduce cognitive impairments in these infants.
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