Extremely pretem infants in Tunisia: Where are we now?

Extremely preterm infants are newborns born before 28 weeks of gestation. Survival of these immature newborns depends on resuscitation and the quality of care during hospitalization. Objective: To determine survival and neurologic outcomes at 2 years after extremely preterm birth. Methods: It is a retrospective multicentric study in 5 neonatal intensive care units (NICU) in 2012-2013. All live births less than 28 weeks gestation were included. Results: A total of 109 births were recorded. Prenatal corticosteroids were given in 47% of cases. Mean weight was 989g and mean age was 26 weeks gestation. Ninety percent of patients had respiratory distress syndrome and 67% of them needed respiratory support. Surfactant was given to 29% of newborns. The mortality rate at discharge was 76%.The first cause of mortality was nosocomial infections. At the corrected age of 2 years, 27% of survivors had abnormal neurologic outcome. Conclusion: In our study, survival and neurologic outcomes of extremely preterm infants were poor. In this high-risk population, improving perinatal care remains a challenge to improve long-term outcome in Tunisia.