A New Risk Calculator to Predict Infant Survival between 22 0/7 – 25 6/7 weeks of Gestation

Abstract

Abstract Objective: As current periviable survival calculators account for only five characteristics, this study aimed to create a predictive calculator for periviable infant survival that accounts for any variable associated with survival. Study Design: US population-based cohort study of livebirths between 22 0/7 – 25 6/7 weeks of gestation from 2009 through 2013 to identify factors associated with neonatal survival. Multivariate logistic regression estimated the association of factors on risk of survival with Hosmer-Lemeshow calibration for test of fit. Results: Variables in the model by magnitude of influence were birthweight, gestational age, sex, antenatal steroid exposure, resuscitation, presentation, mode of delivery and multifetal gestation. Receiver operator characteristic (ROC) curve achieved AUC of 0.800 (95% CI 0.795-0.804), higher than presently available periviable calculators. External validation demonstrated a consistent measure of discrimination (AUC 0.800, 95% CI 0.790-0.809). Conclusion: The calculator is available at https://stage.ob.tools/calc/elbw (username:elbw@ob.tools, password: personalizeCare) for use by health care providers in counseling women with threatening periviable birth.