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Management and outcomes of extreme preterm birth

Andrei S Morgan, Marina Mendonça, Nicole Thiele, Anna L David

2022BMJ116 citationsDOIOpen Access PDF

Abstract

### What you need to know Extreme preterm birth, defined as birth before 28 weeks’ gestational age (box 1),1 affects about two to five in every 1000 pregnancies, and varies slightly by country and by definitions used. Severe maternal morbidity, including sepsis and peripartum haemorrhage, affects around a quarter of mothers delivering at these gestations.2 For the babies, survival and morbidity rates vary, particularly by gestational age at delivery but also according to other risk factors (birth weight and sex, for example) and by country.34 In this update, we focus on high income countries and provide a broad overview of extreme preterm birth epidemiology, recent changes, and best practices in obstetric and neonatal management, including new treatments such as antenatal magnesium sulphate or changes in delivery management such as delayed cord clamping and placental transfusion. We cover short and long term medical, psychological, and experiential consequences for individuals born extremely preterm, their mothers and families, as well as preventive measures that may reduce the incidence of extreme preterm birth. Box 1 ### Key definitions #### World Health Organization definitions relating to preterm birth #### Preterm #### Moderate to late pretermRETURN TO TEXT

Topics & Concepts

MedicineGestational ageObstetricsPregnancyIncidence (geometry)Premature birthLow birth weightNeonatal sepsisBirth weightPediatricsPreterm deliveryInfant mortalitySepsisQuarter (Canadian coin)ChildbirthSmall for gestational ageAdvanced maternal agePerinatal mortalityGestationMEDLINEPreterm Birth and ChorioamnionitisNeonatal Respiratory Health ResearchInfant Development and Preterm Care
Management and outcomes of extreme preterm birth | Litcius