{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:32:50Z","timestamp":1789788770479,"version":"4.0.1"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2022,8,16]]},"abstract":"\n Importance<\/jats:title>\n Birth in the periviable period between 22 weeks 0 days and 25 weeks 6 days\u2019 gestation is a major source of neonatal morbidity and mortality, and the decision to initiate active life-saving treatment is challenging.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess whether the frequency of active treatment among live-born neonates in the periviable period has changed over time and whether active treatment differed by gestational age at birth and race and ethnicity.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Serial cross-sectional descriptive study using National Center for Health Statistics natality data from 2014 to 2020 for 61\u202f908 singleton live births without clinical anomalies between 22 weeks 0 days and 25 weeks 6 days in the US.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Year of delivery, gestational age at birth, and race and ethnicity of the pregnant individual, stratified as non-Hispanic Asian\/Pacific Islander, non-Hispanic Black, Hispanic\/Latina, and non-Hispanic White.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Active treatment, determined by whether there was an attempt to treat the neonate and defined as a composite of surfactant therapy, immediate assisted ventilation at birth, assisted ventilation more than 6 hours in duration, and\/or antibiotic therapy. Frequencies, mean annual percent change (APC), and adjusted risk ratios (aRRs) were estimated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 26\u202f986\u202f716 live births, 61\u202f908 (0.2%) were periviable live births included in this study: 5% were Asian\/Pacific Islander, 37% Black, 24% Hispanic, and 34% White; and 14% were born at 22 weeks, 21% at 23 weeks, 30% at 24 weeks, and 34% at 25 weeks. Fifty-two percent of neonates received active treatment. From 2014 to 2020, the overall frequency (mean APC per year) of active treatment increased significantly (3.9% [95% CI, 3.0% to 4.9%]), as well as among all racial and ethnic subgroups (Asian\/Pacific Islander: 3.4% [95% CI, 0.8% to 6.0%]); Black: 4.7% [95% CI, 3.4% to 5.9%]; Hispanic: 4.7% [95% CI, 3.4% to 5.9%]; and White: 3.1% [95% CI, 1.1% to 4.4%]) and among each gestational age range (22 weeks: 14.4% [95% CI, 11.1% to 17.7%] and 25 weeks: 2.9% [95% CI, 1.5% to 4.2%]). Compared with neonates born to White individuals (57.0%), neonates born to Asian\/Pacific Islander (46.2%; risk difference [RD], \u221210.81 [95% CI, \u221212.75 to \u22128.88]; aRR, 0.82 [95% CI, [0.79-0.86]), Black (51.6%; RD, \u22125.42 [95% CI, \u22126.36 to \u22124.50]; aRR, 0.90 [95% CI, 0.89 to 0.92]), and Hispanic (48.0%; RD, \u22129.03 [95% CI, \u221210.07 to \u22127.99]; aRR, 0.83 [95% CI, 0.81 to 0.85]) individuals were significantly less likely to receive active treatment.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n From 2014 to 2020 in the US, the frequency of active treatment among neonates born alive between 22 weeks 0 days and 25 weeks 6 days significantly increased, and there were differences in rates of active treatment by race and ethnicity.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2022.12841","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T11:03:31Z","timestamp":1660647811000},"page":"652","source":"Crossref","is-referenced-by-count":54,"title":["Trends in Active Treatment of Live-born Neonates Between 22 Weeks 0 Days and 25 Weeks 6 Days by Gestational Age and Maternal Race and Ethnicity in the US, 2014 to 2020"],"prefix":"10.1001","volume":"328","author":[{"given":"Kartik K.","family":"Venkatesh","sequence":"first","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney D.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus"},{"name":"Center for Perinatal Research, 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