Certain Factors Influence Survival of Premies | News | Loyola Medicine
Monday, December 8, 2014

Certain factors influence survival and prognosis for premature infants

Loyola study sheds light on characteristics that protect infants born early

MAYWOOD, Ill.  – Multiple factors influence how well a severely premature infant (23 weeks gestation) will do after birth and over the long-term, according to researchers at Loyola University Chicago Stritch School of Medicine. These findings were published in the latest issue of the American Journal of Perinatology.

Researchers found that males, multiples and premature infants born in a hospital without a neonatal intensive care unit had a significantly higher death rate. Lack of exposure to steroids before birth and lower birth weights also significantly increased the risk for disability. Some studies suggested that babies born via c-section had survival advantages. African-American infants also had higher survival rates in certain studies, but conflicting evidence remains on the role of race and prognosis for these infants.

“The survival of extremely premature infants has improved considerably over the past three decades,” said Jonathan Muraskas, MD, lead author, co-medical director, neonatal intensive care unit, Loyola University Health System, and professor, neonatology, Stritch. “Despite these survival rates, the number of infants born with severe or profound developmental disabilities remains high. This study sheds light on factors that may protect these infants.”

These data come from a retrospective review over a 25-year period (1987 – 2011) of 87 successfully resuscitated infants at 23 weeks of pregnancy. Researchers studied the effects of poor prenatal care, race, gender, inflammation of fetal membranes, steroid use during pregnancy, delivery route and location, Apgar score, birth weight and multiple births on short and long-term outcomes.

Forty-three percent of the infants in the study did not survive. Eighty-eight percent of the survivors were evaluated at 2 years of age with 66 percent diagnosed with moderate-to-severe neurological impairment.

“There is no consensus on early treatment strategies that can accurately predict survival and profound developmental impairments based on observations in the first 48 hours of life,” study authors noted. “Infants born 16 – 17 weeks early can survive, but may have cerebral palsy, blindness and deafness and may require significant resources for the rest of their life. This study will help to identify those infants at risk and help us guide how we care for them.”

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 133,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.