{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:32:49Z","timestamp":1789788769710,"version":"4.0.1"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>We sought to determine if a center\u2019s approach to care of premature infants at the youngest gestational ages (22\u201324 weeks\u2019 gestation) is associated with clinical outcomes among infants of older gestational ages (25\u201327 weeks\u2019 gestation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Inborn infants of 401 to 1000 g birth weight and 22 0\/7 to 27 6\/7 weeks\u2019 gestation at birth from 2002 to 2008 were enrolled into a prospectively collected database at 20 centers participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Markers of an aggressive approach to care for 22- to 24-week infants included use of antenatal corticosteroids, cesarean delivery, and resuscitation. The primary outcome was death before postnatal day 120 for infants of 25 to 27 weeks\u2019 gestation. Secondary outcomes were the combined outcomes of death or a number of morbidities associated with prematurity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Our study included 3631 infants 22 to 24 weeks\u2019 gestation and 5227 infants 25 to 27 weeks\u2019 gestation. Among the 22- to 24-week infants, use of antenatal corticosteroids ranged from 28% to 100%, cesarean delivery from 13% to 65%, and resuscitation from 30% to 100% by center. Centers with higher rates of antenatal corticosteroid use in 22- to 24-week infants had reduced rates of death, death or retinopathy of prematurity, death or late-onset sepsis, death or necrotizing enterocolitis, and death or neurodevelopmental impairment in 25- to 27-week infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>This study suggests that physicians\u2019 willingness to provide care to extremely low gestation infants as measured by frequency of use of antenatal corticosteroids is associated with improved outcomes for more-mature infants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2011-2216","type":"journal-article","created":{"date-parts":[[2012,5,28]],"date-time":"2012-05-28T20:24:14Z","timestamp":1338236654000},"page":"e1508-e1516","source":"Crossref","is-referenced-by-count":81,"title":["Approach to Infants Born at 22 to 24 Weeks\u2019 Gestation: Relationship to Outcomes of More-Mature Infants"],"prefix":"10.1542","volume":"129","author":[{"given":"P. Brian","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namasivayam","family":"Ambalavanan","sequence":"additional","affiliation":[{"name":"Division of Neonatology, University of Alabama at Birmingham, Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Li","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Michael","family":"Cotten","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Laughon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele C.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Rainbow Babies & Children\u2019s Hospital, Case Western Reserve University, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhik","family":"Das","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Iowa, Iowa City, Iowa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldemar A.","family":"Carlo","sequence":"additional","affiliation":[{"name":"Division of Neonatology, University of Alabama at Birmingham, Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J.","family":"Stoll","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine, and Department of Pediatrics, Children\u2019s Healthcare of Atlanta, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seetha","family":"Shankaran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wayne State University, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbot R.","family":"Laptook","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Women & Infants\u2019 Hospital, Brown University, Providence, Rhode Island; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary D.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald N.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Generic Database Subcommittee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Eunice Kennedy Shriver National Institute of Child Health","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Human Development Neonatal Research Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2012,6,1]]},"reference":[{"issue":"16","key":"2021120903444605600_B1","doi-asserted-by":"crossref","first-page":"1672","DOI":"10.1056\/NEJMoa073059","article-title":"Intensive care for extreme prematurity\u2014moving beyond gestational age.","volume":"358","author":"Tyson","year":"2008","journal-title":"N Engl J Med"},{"issue":"3","key":"2021120903444605600_B2","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1542\/peds.2009-2959","article-title":"Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network.","volume":"126","author":"Stoll","year":"2010","journal-title":"Pediatrics"},{"issue":"4","key":"2021120903444605600_B3","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1542\/peds.113.4.781","article-title":"Center differences and outcomes of extremely low birth weight infants.","volume":"113","author":"Vohr","year":"2004","journal-title":"Pediatrics"},{"issue":"6","key":"2021120903444605600_B4","doi-asserted-by":"crossref","first-page":"511","DOI":"10.7326\/0003-4819-137-6-200209170-00012","article-title":"Is volume related to outcome in health care? 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