The gestational age has been set as the yard stick to predict the survival of the neonate, a long time ago. This factor is used to predict that either a very low birth weight neonate survives and thrives or not. But now four more factors have added which can help predict a preemie’s outcome have been mentioned by the National Institutes of Health Neonatal Research Network, of which Yale is a member.
The additional four factors are following. First factor is Birth Weight. Weight of baby counts, as so many under weight infants has low chances of survival. These got infections like neonatal sepsis, jaundice etc. Second factor is Gender which also effects the survival. Third one is the Twin Babies and the last factor is whether the mother was given antenatal steroid mediation to aid the infant lung development. These all factors affect survival ability and risk of being disabling, according to an article, in the New England Journal of Medicine by a group of researchers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network. The 19-center network includes Yale School of Medicine and Yale-New Haven Hospital
These all factors are equally important as gestational age. Researcher used a statistical tool known as outcome estimator to assess survival chances. Study has shown that the babies which have low birth weight are easily attacked by the infection due to which mortality increases. Such babies have lot of chances of survival along with any disability as compare to those which has correct or high weight at birth. Researchers also found that baby girl has more chances to survive than the baby boy. It was only the observation of their study and the exact reason is still unknown. They also found that an infant’s chances of survival without disability are enhanced, if their mothers had been given antenatal steroids which help in metamorphosis and fully develop lungs.
As the twin babies may delivered due to some abnormality so the chances of mental disability has been seen in such cases.
Dr. Mark Mercurio, M.D, associate professor of pediatrics at Yale School of Medicine said, “There is a grey zone of survivability at different gestational ages, and it is impossible to predict the outcome with perfect accuracy, but these new statistical tools are a tremendous aid to us as physicians, particularly when counseling parents faced with agonizing decisions for their extreme preemies” while attending pediatricians at Yale-New Haven Hospital and chair of the Pediatric Ethics Committee. “We are able to give parents a better idea of what the child’s chances of survival are, and in many cases we defer to the judgment of informed parents.”
Dr Mercurio said in addition to survivability prediction, the factors also help to draw a clear picture of the chances of disability. Developmental problems commonly affecting extremely premature infants include cerebral palsy, mental impairment, vision impairment and hearing loss”. The team used standardized measures of mental development, hearing and vision to count the health status of surviving infants when they were 18 to 22 months of age. 49% of the infants among which the study was conducted were dead, 21 percent survived without any disability, and the rest of them experienced some disability.
Although the new factors are helpful in predicting the child survivability still these are not hundred percent authentic. More studies are required to strengthen them but right now these factors are enough supportive in improving the infants survival.
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