ABSTRACT
During a 10-year period, 1977 to 1986, 233 (53%) of 442 inborn live births between
23 and 28 weeks' gestation survived; their 1-year survival rate was 7% at 23 weeks,
30% at 24 weeks, 31 % at 25 weeks, 55% at 26 weeks, 67% at 27 weeks, and 71 % at 28
weeks. No significant change in survival rate was observed over the years. Twelve
percent of pregnancies and 20% of infants were multiple gestations. Singleton births
had significantly higher survival rates compared with multiple births (58% versus
41%). The obstetric intervention rate, as measured by the frequency of cesarean section,
increased significantly over the years: from 15% in 1977-1978 to 33% in 1985-1986.
The neonatal intervention rate, as measured by the frequency of live births offered
neonatal intensive care, remained unchanged. Ten percent were not treated: 4% had
major malformations and 6% were considered “nonviable.” Active perinatal management,
which assumed fetal-neonatal viability, accounted for better survival rates compared
with centers with a more passive management policy. Information on survival based
on gestational cohorts plays an important role in helping obstetricians, neonatologists,
and parents make appropriate management decisions.
