{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:00:34Z","timestamp":1792004434171,"version":"4.4.0"},"reference-count":59,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Advances in medical care and clinician experience have lowered the gestational age at which resuscitation is considered for extremely premature infants. Some centers now offer trials of resuscitation at 21 weeks\u2019 gestational age. Minimal data are available to guide this practice.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To describe morbidities and outcomes of resuscitated infants at 21 weeks\u2019 gestational age.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective case series included all infants born at 21 weeks\u2019 gestational age in a single-center level IV academic neonatal intensive care unit (NICU) at the University of Iowa from January 1, 2010, through February 28, 2025. Data were analyzed from April 1 to August 15, 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Extremely preterm birth at a gestational age of 21 weeks.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Demographic characteristics, therapies, morbidities, and test results were collected throughout hospitalizations from electronic medical records for extremely premature infants who received any attempted resuscitation and their mothers, including hourly cardiorespiratory data for the first 72 hours for infants admitted to the NICU. Postdischarge outcomes through the end of the study period were collected as available.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Twenty-two infants were born alive at 21 weeks\u2019 gestational age during the study period, and an additional 230 were stillborn. Resuscitation was attempted in 17 (77%) of the infants born alive; of these, 6 (35%) survived to discharge from the NICU (earliest in 2021; youngest, 21 weeks, 0 days; birth weight, 285-430 g), 1 (6%) remained hospitalized, and 10 (59%) died. All births were inborn vaginal deliveries. Infants who survived (including the infant who remained hospitalized) were less likely part of a multiple gestation compared with those who did not (1 of 7 [14%] vs 6 of 10 [60%]) and more likely exposed to a complete course of antenatal corticosteroids (3 of 7 [43%] vs 0 of 10). Most of the infants who survived had early cardiorespiratory instability treated with vasoactive medications and\/or inhaled nitric oxide (5 [71%]). Three (43%) had no or grade 1 intraventricular hemorrhage (IVH), 2 (29%) had grade 2 IVH, and 2 had severe (grade 3) IVH (29%); none required neurosurgical intervention. The 6 infants who were discharged received low-flow supplemental oxygen, and none required tracheostomy. Rates of resuscitation increased during the study period.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this case series of infants born alive at 21 weeks\u2019 gestational age, selective resuscitation resulted in 35% survival to discharge, in some cases with minimal morbidities. These descriptive data may prompt prospective study and reporting at this gestational age. Long-term outcome data are needed.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.48211","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T16:30:26Z","timestamp":1765557026000},"page":"e2548211","source":"Crossref","is-referenced-by-count":15,"title":["Outcomes of Infants Born at 21 Weeks\u2019 Gestational Age"],"prefix":"10.1001","volume":"8","author":[{"given":"Rachael M.","family":"Hyland","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatice Dilara","family":"Mat","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Boly","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brady J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy H.","family":"Stanford","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi M.","family":"Harmon","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R.","family":"Bermick","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca Chuffo","family":"Davila","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarah T.","family":"Colaizy","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Dagle","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Klein","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea L.","family":"Greiner","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Bell","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"McNamara","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"University of Iowa Neonatology Program","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aunum P.","family":"Akhter","sequence":"additional","affiliation":[{"name":"for the University of Iowa Neonatology Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy A.","family":"Hobson","sequence":"additional","affiliation":[{"name":"for the University of Iowa Neonatology Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey A.","family":"Knake","sequence":"additional","affiliation":[{"name":"for the University of Iowa Neonatology Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie S.","family":"Lee","sequence":"additional","affiliation":[{"name":"for the University of Iowa Neonatology Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie B.","family":"Lindower","sequence":"additional","affiliation":[{"name":"for the University of Iowa Neonatology Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenda K.","family":"Rabe","sequence":"additional","affiliation":[{"name":"for the University of Iowa Neonatology Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrianne R.","family":"Bischoff","sequence":"additional","affiliation":[{"name":"for the University of Iowa Neonatology Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle R.","family":"Rios","sequence":"additional","affiliation":[{"name":"for the University of Iowa Neonatology Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Roghair","sequence":"additional","affiliation":[{"name":"for the University of Iowa Neonatology Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel W.","family":"Wong","sequence":"additional","affiliation":[{"name":"for the University of Iowa Neonatology Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"John T.","family":"Wren","sequence":"additional","affiliation":[{"name":"for the University of Iowa Neonatology Program"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"issue":"1","key":"zoi251297r1","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1111\/apa.16084","article-title":"Birth outcomes between 22 and 26 weeks\u2019 gestation in national population-based cohorts from Sweden, England and France.","volume":"111","author":"Morgan","year":"2022","journal-title":"Acta Paediatr"},{"issue":"8","key":"zoi251297r2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.24226","article-title":"Neonatal mortality disparities by gestational age in European countries.","volume":"7","author":"Sartorius","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"1","key":"zoi251297r3","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1542\/peds.2012-2857","article-title":"Outcomes of infants born at 22 and 23 weeks\u2019 gestation.","volume":"132","author":"Ishii","year":"2013","journal-title":"Pediatrics"},{"key":"zoi251297r4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e7976","article-title":"Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies).","volume":"345","author":"Costeloe","year":"2012","journal-title":"BMJ"},{"issue":"4","key":"zoi251297r5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2024-065963","article-title":"Survival of infants born at 22 to 25 weeks\u2019 gestation receiving care in the NICU: 2020-2022.","volume":"154","author":"Edwards","year":"2024","journal-title":"Pediatrics"},{"issue":"1","key":"zoi251297r6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2017-000211","article-title":"Changes in survival and neurodevelopmental outcomes of infants born at <25 weeks\u2019 gestation: a retrospective observational study in tertiary centres in Japan.","volume":"2","author":"Kono","year":"2018","journal-title":"BMJ Paediatr Open"},{"issue":"6","key":"zoi251297r8","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-0103","article-title":"Two-year neurodevelopmental outcome of an infant born at 21 weeks\u2019 4 days\u2019 gestation.","volume":"140","author":"Ahmad","year":"2017","journal-title":"Pediatrics"},{"issue":"3","key":"zoi251297r9","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2018.33.e22","article-title":"The youngest survivor with gestational age of 21 5\/7 weeks.","volume":"33","author":"Sung","year":"2018","journal-title":"J Korean Med Sci"},{"issue":"2","key":"zoi251297r10","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2022.101326","article-title":"The Tiniest Babies Registry: a registry of survivors born weighing less than 400 grams.","volume":"27","author":"Bell","year":"2022","journal-title":"Semin Fetal Neonatal Med"},{"issue":"19","key":"zoi251297r11","doi-asserted-by":"publisher","first-page":"1801","DOI":"10.1056\/NEJMoa1410689","article-title":"Between-hospital variation in treatment and outcomes in extremely preterm infants.","volume":"372","author":"Rysavy","year":"2015","journal-title":"N Engl J Med"},{"key":"zoi251297r12","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.jpeds.2021.03.006","article-title":"An immature science: intensive care for infants born at =23 weeks of gestation.","volume":"233","author":"Rysavy","year":"2021","journal-title":"J Pediatr"},{"issue":"3","key":"zoi251297r13","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1001\/jama.2021.23580","article-title":"Mortality, in-hospital morbidity, care practices, and 2-year outcomes for extremely preterm infants in the US, 2013-2018.","volume":"327","author":"Bell","year":"2022","journal-title":"JAMA"},{"issue":"10","key":"zoi251297r14","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1001\/jama.2015.10244","article-title":"Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993-2012.","volume":"314","author":"Stoll","year":"2015","journal-title":"JAMA"},{"issue":"7","key":"zoi251297r15","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1001\/jamapediatrics.2016.0207","article-title":"Survival among infants born at 22 or 23 weeks\u2019 gestation following active prenatal and postnatal care.","volume":"170","author":"Mehler","year":"2016","journal-title":"JAMA Pediatr"},{"issue":"1","key":"zoi251297r16","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1136\/archdischild-2022-325164","article-title":"One-year survival and outcomes of infants born at 22 and 23 weeks of gestation in Sweden 2004-2007, 2014-2016 and 2017-2019.","volume":"109","author":"Farooqi","year":"2023","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"1","key":"zoi251297r17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed-2023-000579","article-title":"Effect of national guidance on survival for babies born at 22 weeks\u2019 gestation in England and Wales: population based cohort study.","volume":"2","author":"Smith","year":"2023","journal-title":"BMJ Med"},{"issue":"5","key":"zoi251297r18","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1055\/a-1779-4032","article-title":"Prognosis of 22- and 23-gestational-week-old infants at our facility: a retrospective cohort study.","volume":"41","author":"Yanagisawa","year":"2024","journal-title":"Am J Perinatol"},{"issue":"11","key":"zoi251297r19","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.1038\/s41372-023-01706-4","article-title":"Management and outcomes of periviable neonates born at 22 weeks of gestation: a single-center experience in Japan.","volume":"43","author":"Motojima","year":"2023","journal-title":"J Perinatol"},{"issue":"1","key":"zoi251297r20","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4434","article-title":"Survival and major morbidity of extremely preterm infants: a population-based study.","volume":"138","author":"Anderson","year":"2016","journal-title":"Pediatrics"},{"issue":"7","key":"zoi251297r21","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1056\/NEJMoa1605566","article-title":"Survival and neurodevelopmental outcomes among periviable infants.","volume":"376","author":"Younge","year":"2017","journal-title":"N Engl J Med"},{"issue":"2","key":"zoi251297r22","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-0933","article-title":"Survival and impairment of extremely premature infants: a meta-analysis.","volume":"143","author":"Myrhaug","year":"2019","journal-title":"Pediatrics"},{"key":"zoi251297r23","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.jpeds.2019.08.028","article-title":"Outcomes at 18 to 22 months of corrected age for infants born at 22 to 25 weeks of gestation in a center practicing active management.","volume":"217","author":"Watkins","year":"2020","journal-title":"J Pediatr"},{"key":"zoi251297r24","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.jpeds.2017.12.020","article-title":"Severe neurodevelopmental impairment in neonates born preterm: impact of varying definitions in a Canadian cohort.","volume":"197","author":"Haslam","year":"2018","journal-title":"J Pediatr"},{"issue":"21","key":"zoi251297r25","doi-asserted-by":"publisher","first-page":"1991","DOI":"10.1001\/jama.281.21.1991","article-title":"Differences in preferences for neonatal outcomes among health care professionals, parents, and adolescents.","volume":"281","author":"Saigal","year":"1999","journal-title":"JAMA"},{"issue":"1","key":"zoi251297r26","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.siny.2017.09.003","article-title":"Values-based shared decision-making in the antenatal period.","volume":"23","author":"Kukora","year":"2018","journal-title":"Semin Fetal Neonatal Med"},{"issue":"5","key":"zoi251297r27","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1111\/apa.16690","article-title":"A scoping review of parental values during prenatal decisions about treatment options after extremely premature birth.","volume":"112","author":"de Boer","year":"2023","journal-title":"Acta Paediatr"},{"issue":"2","key":"zoi251297r28","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2024-066148","article-title":"Parental and medical classification of neurodevelopment in children born preterm.","volume":"155","author":"Richter","year":"2025","journal-title":"Pediatrics"},{"issue":"4","key":"zoi251297r29","doi-asserted-by":"publisher","first-page":"e217","DOI":"10.1542\/neo.21-4-e217","article-title":"Historical perspectives: shared decision making in the NICU.","volume":"21","author":"Sullivan","year":"2020","journal-title":"Neoreviews"},{"issue":"6","key":"zoi251297r30","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1055\/s-0041-1730430","article-title":"What information do clinicians deem important for counseling parents facing extremely early deliveries? results from an online survey.","volume":"40","author":"Kim","year":"2023","journal-title":"Am J Perinatol"},{"key":"zoi251297r31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2024.113948","article-title":"Community considerations for aggressive intensive care therapy for infants <24+0 weeks of gestation.","volume":"268","author":"Guill\u00e9n","year":"2024","journal-title":"J Pediatr"},{"issue":"6","key":"zoi251297r32","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-3972","article-title":"Physicians\u2019 attitudes on resuscitation of extremely premature infants: a systematic review.","volume":"143","author":"Cavolo","year":"2019","journal-title":"Pediatrics"},{"issue":"7","key":"zoi251297r33","doi-asserted-by":"publisher","DOI":"10.1016\/j.semperi.2022.151635","article-title":"Contributions of the NICHD neonatal research network\u2019s generic database to documenting and advancing the outcomes of extremely preterm infants.","volume":"46","author":"Bell","year":"2022","journal-title":"Semin Perinatol"},{"issue":"1","key":"zoi251297r34","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.cnc.2023.08.007","article-title":"Care from birth to discharge of infants born at 22 to 23 weeks\u2019 gestation.","volume":"36","author":"Dagle","year":"2024","journal-title":"Crit Care Nurs Clin North Am"},{"issue":"1","key":"zoi251297r35","doi-asserted-by":"publisher","DOI":"10.1016\/j.semperi.2021.151545","article-title":"Cardiorespiratory management of infants born at 22 weeks\u2019 gestation: the Iowa approach.","volume":"46","author":"Dagle","year":"2022","journal-title":"Semin Perinatol"},{"issue":"3","key":"zoi251297r36","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1164\/rccm.202212-2291OC","article-title":"Impact of early hemodynamic screening on extremely preterm outcomes in a high-performance center.","volume":"208","author":"Giesinger","year":"2023","journal-title":"Am J Respir Crit Care Med"},{"issue":"2","key":"zoi251297r37","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1097\/MOP.0000000000001104","article-title":"First intention high-frequency jet ventilation for periviable infants.","volume":"34","author":"Elgin","year":"2022","journal-title":"Curr Opin Pediatr"},{"issue":"1","key":"zoi251297r38","doi-asserted-by":"publisher","first-page":"e41","DOI":"10.1542\/neo.26-1-004","article-title":"Skin care of infants born at 21-23 weeks\u2019 gestation.","volume":"26","author":"Hobson","year":"2025","journal-title":"Neoreviews"},{"issue":"2","key":"zoi251297r39","doi-asserted-by":"publisher","DOI":"10.1016\/j.semperi.2023.151721","article-title":"Impact of early screening echocardiography and targeted PDA treatment on neonatal outcomes in \u201c22-23\u201d week and \u201c24-26\u201d infants.","volume":"47","author":"Giesinger","year":"2023","journal-title":"Semin Perinatol"},{"issue":"4","key":"zoi251297r40","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1002\/ppul.23020","article-title":"Respiratory severity score on day of life 30 is predictive of mortality and the length of mechanical ventilation in premature infants with protracted ventilation.","volume":"50","author":"Malkar","year":"2015","journal-title":"Pediatr Pulmonol"},{"issue":"9","key":"zoi251297r41","doi-asserted-by":"publisher","first-page":"2337","DOI":"10.1038\/s41372-021-01030-9","article-title":"Maximum vasoactive-inotropic score and mortality in extremely premature, extremely low birth weight infants.","volume":"41","author":"Aziz","year":"2021","journal-title":"J Perinatol"},{"issue":"1","key":"zoi251297r42","doi-asserted-by":"publisher","DOI":"10.2196\/16204","article-title":"PediTools electronic growth chart calculators: applications in clinical care, research, and quality improvement.","volume":"22","author":"Chou","year":"2020","journal-title":"J Med Internet Res"},{"issue":"6","key":"zoi251297r43","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1111\/j.1442-200X.2011.03381.x","article-title":"Meconium-related ileus in extremely low-birthweight neonates: etiological considerations from histology and radiology.","volume":"53","author":"Kubota","year":"2011","journal-title":"Pediatr Int"},{"issue":"9","key":"zoi251297r44","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1111\/dmcn.15977","article-title":"The Hammersmith Infant Neurological Exam Scoring Aid supports early detection for infants with high probability of cerebral palsy.","volume":"66","author":"Fehlings","year":"2024","journal-title":"Dev Med Child Neurol"},{"issue":"2","key":"zoi251297r45","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.ajog.2020.07.051","article-title":"Proactive neonatal treatment at 22 weeks of gestation: a systematic review and meta-analysis.","volume":"224","author":"Backes","year":"2021","journal-title":"Am J Obstet Gynecol"},{"issue":"9","key":"zoi251297r46","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.33331","article-title":"Association of antenatal steroid exposure at 21 to 22 weeks of gestation with neonatal survival and survival without morbidities.","volume":"5","author":"Chawla","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"4","key":"zoi251297r47","doi-asserted-by":"publisher","first-page":"e187","DOI":"10.1097\/AOG.0000000000002352","article-title":"Obstetric care consensus No. 6: periviable birth.","volume":"130","author":"American College of Obstetricians and Gynecologists","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"1","key":"zoi251297r49","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1097\/AOG.0000000000005352","article-title":"Antenatal corticosteroids at 21-23 weeks of gestation.","volume":"143","author":"Battarbee","year":"2024","journal-title":"Obstet Gynecol"},{"issue":"5","key":"zoi251297r50","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2023.101482","article-title":"Success rates and adverse events during neonatal intubation: lessons learned from an international registry.","volume":"28","author":"Herrick","year":"2023","journal-title":"Semin Fetal Neonatal Med"},{"issue":"3","key":"zoi251297r51","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1038\/s41372-022-01582-4","article-title":"Response categorization and outcomes in extremely premature infants born at 22-26 weeks gestation that received inhaled nitric oxide for hypoxic respiratory failure.","volume":"43","author":"Boly","year":"2023","journal-title":"J Perinatol"},{"issue":"2","key":"zoi251297r52","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1136\/archdischild-2024-327347","article-title":"Impact of targeted neonatal echocardiography consultations for critically sick preterm neonates.","volume":"110","author":"Joye","year":"2025","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"zoi251297r53","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1016\/j.jpeds.2022.03.022","article-title":"Dopamine and neonatal pulmonary hypertension\u2014pressing need for a better pressor?","volume":"246","author":"McNamara","year":"2022","journal-title":"J Pediatr"},{"issue":"1","key":"zoi251297r54","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1038\/s41372-018-0248-y","article-title":"Outcomes following a comprehensive versus a selective approach for infants born at 22 weeks of gestation.","volume":"39","author":"Backes","year":"2019","journal-title":"J Perinatol"},{"key":"zoi251297r55","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-025-02252-x","article-title":"It\u2019s the little things: a framework and guidance for programs to care for infants 22-23 weeks\u2019 gestational age.","author":"Bernardini","year":"2025","journal-title":"J Perinatol"},{"issue":"3","key":"zoi251297r56","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1038\/s41390-020-0993-4","article-title":"Pulmonary hypertension in bronchopulmonary dysplasia.","volume":"89","author":"Hansmann","year":"2021","journal-title":"Pediatr Res"},{"issue":"6","key":"zoi251297r57","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1038\/s41372-022-01374-w","article-title":"Extremely premature infants born at 23-25 weeks gestation are at substantial risk for pulmonary hypertension.","volume":"42","author":"Sallmon","year":"2022","journal-title":"J Perinatol"},{"issue":"4","key":"zoi251297r58","doi-asserted-by":"publisher","first-page":"558.e1","DOI":"10.1016\/j.ajog.2021.10.036","article-title":"Maternal morbidity after preterm premature rupture of membranes at <24 weeks\u2019 gestation.","volume":"226","author":"Sklar","year":"2022","journal-title":"Am J Obstet Gynecol"},{"key":"zoi251297r59","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2024.114033","article-title":"The landscape of resource utilization after resuscitation of 22-, 23-, and 24-weeks\u2019 gestation infants.","volume":"270","author":"Daisy","year":"2024","journal-title":"J Pediatr"},{"key":"zoi251297r7","unstructured":"The Tiniest Babies. Iowa Health Care. Accessed February 1, 2025. https:\/\/webapps1.healthcare.uiowa.edu\/tiniestbabies"},{"key":"zoi251297r48","unstructured":"American College of Obstetricians and Gynecologists. Use of antenatal corticosteroids at 22 weeks of gestation. October 2022. Accessed February 1, 2025. https:\/\/www.acog.org\/clinical\/clinical-guidance\/practice-advisory\/articles\/2021\/09\/use-of-antenatal-corticosteroids-at-22-weeks-of-gestation"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2842687\/hyland_2025_oi_251297_1768331292.32009.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T16:00:46Z","timestamp":1768924846000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2842687"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":59,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.48211","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]}}}