Resumen

LOZANO-GONZALEZ, Carlos Humberto; FLORES-TAMEZ, María Estela; CASTRO-MEJIA, Sandra  y  LOZANO-FLORES, Jorge Alfredo. Neonatal limits viability. Perinatol. Reprod. Hum. [online]. 2013, vol.27, n.2, pp.79-85. ISSN 2524-1710.

Background: Determine the limit of neonatal viability is desirable to avoid interventions that are costly, painful and unnecessary in the child who has no chance of survival. However, setting a threshold of viability is a major challenge because it is uncertain which extremely premature newborn may have a reasonable chance of survival. Methods: We collected information from 17,979 births in a four years period (2009-2012), studying all 71 infants born under 28 weeks gestation in a private Maternity Center of Monterrey, Nuevo León, México. Mainly focusing on the event occurrence and its outcome, including perinatal mortality rate, proportion of births occurrence at each gestational age, less than 28 weeks. Probability of death for each age was estimated, correlating death with age, gender and survival days. Results: From 17,979 live births only 0.39% (71) was less than 28 weeks gestation. Perinatal mortality rate for the studied period was 26.55 per 1,000 live births. There were a 2.88% of infants with 23 or less weeks. The probability of birth for each group age, less than 28 weeks is considered useful only for this population, and not to be regarded as a forecast for general application, since each gestational age sample is relatively small. The average life expectancy for babies 23 weeks of gestation was poor. There was a negative correlation for death and weight, not significant for gender and death, and positive for weight and days of life. Conclusions: While our study may be considered with limitations, it is based to serve the purposes of a well demographically defined population, and our result concurs with most guidelines and recommendations given in the international literature. We conclude that at 23 weeks gestation or less is fine to give palliative care. The limits of neonatal viability is not a birth weight or a certain gestational age, there are moral, ethical and humanitarian implications, decisions regarding procedures on extremely premature, should be supported by published consensus medically endorsed.

Palabras llave : Neonatal limits viability; extremely premature.