ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Neonatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1673565
Determinants of Survival in Extremely Preterm Infants Born at 22–23 Weeks: A Retrospective Cohort Study
Provisionally accepted
Tomonori Kurimoto*
Takuya TokuhisaMasaya KibeHiroshi Ohashi
Eiji HirakawaTakatsugu MaedaMasato Kamitomo- Kagoshima City Hospital, Kagoshima, Japan
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ABSTRACT Background: This study investigated the risk factors associated with mortality in infants born at 22–23 weeks and assessed the impact of different variables on survival outcomes. Methods: This retrospective study included 185 infants born at 22–23 weeks at a single tertiary care center (2006–2023). Univariate and logistic regression analyses identified independent predictors of mortality. Results: Among 185 infants, 64 (34.6%) did not survive. Mortality was associated with a lower birth weight (509 g vs. 564 g, p=0.0001) and higher rates of small for gestational age (SGA; 21.9% vs. 7.4%, p=0.009). Independent predictors included SGA (odds ratio [OR]: 5.8), tension pneumothorax (OR: 9.9), severe intraventricular hemorrhage (OR: 3.3), focal intestinal perforation (OR: 4.1), necrotizing enterocolitis (OR: 18.9), and early-onset sepsis (OR: 9.7). Cesarean delivery was associated with reduced mortality (OR: 0.3). Conclusions: Targeted management of these risk factors and cesarean delivery may improve the outcomes in this population.
Keywords: Extremely preterm infant, 22-23 weeks of gestation, small for gestational age, Necrotizing entercolitis, Intraventriclar hemorrhage, focal intestinal perforation, tension pneumothorax, Cesearean delivery
Received: 26 Jul 2025; Accepted: 23 Sep 2025.
Copyright: © 2025 Kurimoto, Tokuhisa, Kibe, Ohashi, Hirakawa, Maeda and Kamitomo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tomonori Kurimoto, maron.n.tomo.o@gmail.com
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