Trends in Active Treatment of Live-born Neonates Between 22 Weeks 0 Days and 25 Weeks 6 Days by Gestational Age and Maternal Race and Ethnicity in the United States, 2014-2020

Abstract

(JAMA. 2022;328:652–662) In 2015, 0.4% of all deliveries in the United States occurred between 22 weeks 0 days gestation and 25 weeks 6 days gestation, but these periviable births accounted for 40% of neonatal deaths. Decisions regarding treatment of these neonates can be difficult and involve several factors, most of all gestational age at delivery, but also parental preferences, neonatal characteristics, obstetric characteristics, and clinician characteristics. Neonatal morbidity and mortality varies by race, with a higher mortality rate for Black infants compared with White infants. Previous data from more than a decade ago suggests there may be racial disparities in treatment decisions for periviable neonates. This study aimed to explore treatment decisions among this cohort of neonates from 2014 to 2020 and investigate whether these decisions vary by maternal race and ethnicity.