{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:06:19Z","timestamp":1779789979594,"version":"3.53.1"},"reference-count":47,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Extreme preterm infants (EPI), born at &lt;26\u00a0weeks\u2019 gestation and weighing &lt;750\u00a0g, represent the most vulnerable subset of preterm neonates with the highest risk of mortality and major morbidities. Despite significant advances in neonatal\/perinatal care, outcomes for this population remain a major clinical challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate temporal trends in survival, morbidity profiles, and predictors of in-hospital survival among inborn extreme preterm infants of birth weight &lt;750\u00a0g and gestational age &lt; 26\u00a0weeks over an 18-year period in a tertiary-level neonatal intensive care unit (NICU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 134 inborn EP infants admitted between 2002 and 2019. The primary outcome was survival to hospital discharge; secondary outcomes included rates of several prematurity-related morbidities. Multivariable logistic regression was used to identify independent predictors of survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Survival to discharge increased over time from 29% (2002\u20132007) to 61% (2014\u20132019) (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.009). Antenatal corticosteroid (ACS) (a OR 2.9, 95% CI 1.05\u20138.04,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.049) and cesarean delivery (aOR 2.88, 95% CI 1.03\u20138.07,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.044) were independently associated with increased odds of survival. Early hypotension (aOR 0.28, 95% CI 0.12\u20130.67,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.004) and severe IVH (aOR 0.39, 95% CI 0.16\u20130.94,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.035) were significantly associated with increased mortality. The incidence of severe IVH declined from 46% to 26% over the study period, while rates of PVL and surgical NEC showed downward trends. BPD (51%) and severe ROP (19%) remained relatively unchanged.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Over nearly two decades, survival among extreme preterm infants of birth weight &lt;750\u00a0g ang gestational age &lt;26\u00a0weeks improved significantly. ACS administration and cesarean birth were associated with an increased rate of survival. Early hypotension and severe IVH were predictors of mortality. Severe IVH, PVL, and surgical NEC declined during the last period. Ongoing advances in perinatal care and targeted neonatal interventions are essential to further improve outcomes in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19345798251405222","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T22:42:06Z","timestamp":1765320126000},"page":"429-437","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Extreme preterm infants of birth weight &lt;750\u00a0g and gestational age &lt;26\u00a0weeks, survival trends and morbidity predictors over nearly two decades, single centre experience"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5244-6034","authenticated-orcid":false,"given":"Mansour","family":"Al Qurashi","sequence":"first","affiliation":[{"name":"Ministry of National Guard Health Affairs (MNGHA)"},{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdulaziz Medical City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehab","family":"Hanafi","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs (MNGHA)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5261-9196","authenticated-orcid":false,"given":"Mohammed","family":"Alhindi","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs (MNGHA)"},{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdulaziz Medical City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6072-7058","authenticated-orcid":false,"given":"Yaser","family":"Faden","sequence":"additional","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdulaziz Medical City"},{"name":"MNGHA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs (MNGHA)"},{"name":"King Abdulaziz Medical City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abrar","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs (MNGHA)"},{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdulaziz Medical City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6655-9198","authenticated-orcid":false,"given":"Jubara","family":"Alallah","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs (MNGHA)"},{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdulaziz Medical City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf","family":"Sahafi","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs (MNGHA)"},{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdulaziz Medical City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7396-1855","authenticated-orcid":false,"given":"Hashem","family":"Al Marzouki","sequence":"additional","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdulaziz Medical City"},{"name":"MNGHA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9322-6010","authenticated-orcid":false,"given":"Hend","family":"AlNajjar","sequence":"additional","affiliation":[{"name":"King Abdulaziz Medical City"},{"name":"King Saud Bin Abdul Aziz University for Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Hassosah","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs (MNGHA)"},{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdulaziz Medical City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6379-590X","authenticated-orcid":false,"given":"Muhammad Anwar","family":"Khan","sequence":"additional","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdulaziz Medical City"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"issue":"16","key":"e_1_3_4_2_2","first-page":"1700","article-title":"Outcomes of infants born at 22 to 25 weeks\u2019 gestation","volume":"358","author":"Tyson JE","year":"2008","unstructured":"Tyson JE, Parikh NA, Langer J, et al. 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