Specialties NICU
Published Jul 26, 2003
VickyRN, MSN, DNP, RN
49 Articles; 5,349 Posts
Am working on my lecture about premature babies. Thanks, by the way, for all your help with transcutaneous oxygen pressure monitoring, pulse oximetry, ABGs vs capillary blood gases. Now I have another question and hope you can steer me in the right direction. Having difficulty finding concrete, accurate information about neonatal survival rates--for instance, what is the mortality and morbidity of an infant born at 23 weeks gestation, 24 weeks gestation, 25 weeks, etc on up? Thank you so much for your help!:kiss
dawngloves, BSN, RN
2,399 Posts
This is the most recent stats I could find:
http://home.vicnet.net.au/~garyh/outcome.html
Also, the March of Dimes website has many abstracts. HTH!
Thank you very much. Will check out March of Dimes also!
nicudaynurse
150 Posts
I recently gave a presentation on the "Neurological complications related to prematurity" and the stats that I used were 50-60% of infants born at 23-24 weeks gestation survive and at 26 weeks survival increases to 90%. I'm sure that you are already aware that statistics vary from source to source.
NICU_Nurse, BSN, RN
1,158 Posts
http://www.findarticles.com/cf_o/g2601/0011/2601001109/p1/article.jhtml?term= had an article; this is a cut-and-paste (found on p. 4 of the article):
"Advances in medical care have made it possible for many premature infants to survive and develop normally. However, whether or not a premature infant will survive is still intimately tied to his or her gestational age:
21 weeks or less: 0% survival rate
22 weeks: 0-10% survival rate
23 weeks: 10-35% survival rate
24 weeks: 40-70% survival rate
25 weeks: 50-80% survival rate
26 weeks: 80-90% survival rate
27 weeks: greater than 90% survival rate"
Also: http://www.ucpa.org/ucp_generaldoc.cfm/1/4/24/24-6610/1314 had this (from '97):
Table represents birth weight in the first column and first month mortality rate in the second column birth weight (lbs) 1st month mortality rate per 1000 live births:
1 and under: 869.2
1 to 1 + 12 ounces: 437.5
1 + 12 ounces to 2: 122.4
2 to 2 + 12 ounces: 53.7
2 + 12 ounces to 3: 34.3
3 to 4 + 12 ounces: 18.8
4 + 12 ounces to 5 + 12 ounces: 6.5
5 + 12 ounces to 6+12 ounces: 2.0
Sorry, that one didn't come out quite right. The numbers at the end are the rates per 1000 live births.
Also, I second the March of Dimes site. They have wonderful statistics on prematurity. :)
A big THANK YOU!!!!!!!!!!! :)
This looks good, too:
http://www.sidelinescanada.org/articles/rectre.htm
Trouble is, knowing which one to use in lecture.
Are you going to be incorporating any type of ethical discussion along with this lecture? I think it would be a great addition if you haven't thought of it already. Neonatology brings up so many interesting ethical dilemmas- the field is relatively new, up until 25 years ago or so it was basically survival of the fittest (technologically speaking), when should babies NOT be resuscitated, when should interventions halt, is saving such premature infants fair to the parents who may not realize the severe developmental disabilities that can occur, etc. Also, I've always found it interesting that in my area, abortion clinics will perform abortions up to the 25th week, while we in the NICU are tubing and saving babies who are as young as 22 3/7 weeks. Recently, I heard of a 350 gram baby being intubated (didn't survive). Issues about viability and such. Something to consider if you have the time in your lecture! :)
As far as which statistics to use, if the March of Dimes PeriStats doesn't give you anything concrete (and I'd think they'd be the most updated source; they've just recently put those figures online), I find that using the words/phrases "approximately" and "up to" come in handy.
Thank you so much for all of the info and support. I really like the suggestion about ethical dilemna. I will incorporate that. We rotated one place this summer (LTC for developmentally delayed/profound MR children) in which there were several children with handicaps due to being born too soon. I guess this is the "flip side" to the coin of all the happy stories of preemies who survive and go on to live normal lives.
You know, I was thinking...you might be able to get in contact with someone via the hospital (where your class does clinicals, perhaps? Or if you work PRN somewhere?) who has had a preemie who has recovered well. They might have pictures to share with the class, and maybe you could even have them come in as a special guest for a visit. It would probably be a really positive experience for the students to see a real, live preemie who made it after an NICU stay. Show the pictures of them in the NICU and then get to meet him/her in person? Nice "up" way to round off the lecture.
BTW, I have NO idea how long it is, or how much time you have to devote to it...just throwing ideas out there.
HMMMM... good idea!