A network analysis of timing and conditions present at time of death for periviable infants (22+0–23+6 weeks) admitted to neonatal intensive care after receiving survival-focused care at birth

• DOI: 10.3389/fped.2025.1552352
• Publication Date: 2025-05-15T06:44:19Z
• Authors: J. Peterson; D. M. Smith; E. D. Johnstone; K. Harvey; A. Mahaveer

Advances in neonatal care have resulted improved survival rates for periviable infants (22 + 0-23 6 weeks) with increasing numbers being admitted to intensive units across the United Kingdom. Qualitative research evidences conflict perinatal professionals experience traversing line between providing life-sustaining treatment these infants, whilst not wanting inflict a prolonged period of suffering who will ultimately die. Professionals currently lack adequate prognostic tools accurately predict pre-birth which survive. This study utilises an anonymised dataset from North West Neonatal Network delineate time death profiles (NICU) and explores demographics, timing diagnoses recorded at death. The data show that most died following admission NICU within first seven days after birth [24 born 22 weeks (65%) 55 23 (52%)]. For subsequently on NICU, 89% had 14 birth. Reorientation was as relevant factor minority patients [23 (16%)]. Where active, survival-focused has been initiated, response infant likelihood their emerges over relatively short timeframe admission. lends support trial therapy approach suitable balancing need avoid iatrogenic harm die despite care, denying them chance survival. Management deliveries requires coordinated parallel planning high-quality palliative throughout.