Short Term Survival of Extreme Preterm Newborns at 23–26 Weeks’ Gestation in a Middle East Modern Referral Maternity Hospital

Background: Caring about ELBW newborns at the limit of viability is demanding with a high rate of mortality and long-term morbidity. Society expectations become high and persistent while health care coast inside NICU is very high. Objective: The purpose of this study is to examine the short-term survival (till discharge) of extremely low birth weight (ELBW) newborns at limits of viability 23–26 weeks gestation (WG) age in a large tertiary maternity hospital. Methods: A population-based retrospective study of babies born at 23–26 WG age over 3 years period. Results: Over the study period 2016 to mid-2018, a total of 283 ELBW newborns were delivered in our institute. Of those, 250 were admitted to NICU (88%). The number of newborns who survived till discharge from NICU was 174 (61.5%) while the rate of delivery room death was 33 newborns (11.75%). The survival rates during 2016–2018 period were 35%, 64%, 73%, and 81.4% for 23, 24, 25, and 26 WG respectively. 76 newborns (26.9%) of NICU admissions died before discharge. Most deaths occurred during the first two weeks of life (64%). The main cause of death inside the NICU during the first 2 weeks was respiratory failure, followed by infection. Conclusion: Counseling Parent using local data become more convincing and reflecting local experience. Short term survival rate of ELBW is comparable to those reported in the literature. The first two weeks are very crucial where the mortality rate is highest.