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CME Credit Offered
CME Credit Offered
Abstract Award
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Poster Session 2

(648) Neonatal survival in individuals with periviable pre-eclampsia.

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective:

To compare neonatal survival in pregnancies complicated by preeclampsia versus patients without pre-eclampsia(preE) between 22w0d and 24w6d.   

 

Study Design:

Retrospective cohort study utilizing the US Vital Statistic Natality Birth Data of pregnancies with delivery between 22w0d-24w6d from 2018 to 2022.  Individuals with preeclampsia were compared to individuals delivered during the same gestational age without preeclampsia. The primary outcome is infant survival as documented at the time of birth certificate report . Secondary outcomes include neonatal  seizures and assisted ventilation for >6 hours. Multivariate analysis was completed with Pearson Chi-squared tests to analyze categorical variables. 

Results: A total of 38,024 met inclusion criteria. 253(0.7%) of pregnancies were affected by PreE while 37,660(99.0%) did not have preE. At the time of the birth certificate report, 201(79.4%) infants survived in the preE group compared to 26,691(70.9%) infants in the non-preE group(P< 0.003, OR 1.6; 95% CI: 1.18-2.20). However, when analyzed by gestational age week by week, neonatal survival rates were similar between the two groups: [22 weeks (18(52.9%) preE vs. 3,832(44.7%) non-preE, P=0.336) , 23 weeks( 69(78.4%) preE vs. 8,922(72.1%) non- preE,  P=0.095,  and at 24 weeks(114(87.0%) preE vs.13,937(84.4%) non- preE, p=0.530]. There is a statistically significant difference in number of neonates with seizures (0.4% in the preE group vs 0.2% in the non- preE group P< 0.001) and neonates requiring ventilation for more than 6 hours (33.1% in the preE group versus 32.9% in the non-preE group p< 0.001).

Conclusion:

The overall survival of neonates born in the periviable period in pregnancies complicated by preeclampsia is 79.4%.  The chance of survival increases with each week of continued pregnancy in the periviable period. Given the rarity of periviable preeclampsia, the rates of survival are similar to neonates born in the periviable period for other indications.