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Does active treatment in infants born at 22–23 weeks correlate with outcomes of more mature infants at the same hospital? An analysis of California NICU data, 2015–2019



To investigate whether hospital rates of active treatment for infants born at 22–23 weeks is associated with survival of infants born at 24–27 weeks.

Study design

We included all liveborn infants 22–27 weeks of gestation delivered at California Perinatal Quality Care Collaborative hospitals from 2015 to 2019. We assessed (1) the correlation of active treatment (e.g., endotracheal intubation, epinephrine) in 22–23 week infants and survival until discharge for 24–27 week infants and (2) the association of active treatment with survival using multilevel models.


The 22–23 week active treatment rate was associated with infant outcomes at 22–23 weeks but not 24–27 weeks. A 10% increase in active treatment did not relate to 24–25 week (adjusted OR: 1.00 [95% CI: 0.95–1.05]), or 26–27 week survival (aOR: 1.02 [0.95–1.09]).


The hospital rate of active treatment for infants born at 22–23 weeks was not associated with improved survival for 24–27 week infants.

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Fig. 1: Cohort selection process, CPQCC 2015–2019.
Fig. 2: Comparison of hospital rates of 22-23 week infant active treatment and outcomes of interest by gestational age, CPQCC 2015–2019 (N = 88)a.

Data availability

Data are available upon request and completion of requirements from CPQCC. Code is also available upon request.


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Research reported in this manuscript was supported by the National Institutes of Health under award number R01HD098287. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations



SB and HCL conceived and designed this work and drafted the manuscript. SB conducted the study analysis with input from all other co-authors (HL, MAR, SLC, TL, MB). All authors provided critical feedback on study design and interpretation of results and approved the final version of the manuscript.

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Correspondence to Shalmali Bane.

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Bane, S., Rysavy, M.A., Carmichael, S.L. et al. Does active treatment in infants born at 22–23 weeks correlate with outcomes of more mature infants at the same hospital? An analysis of California NICU data, 2015–2019. J Perinatol 42, 1301–1305 (2022).

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