Significant improvement in survival outcomes of trisomy 18 with neonatal intensive care compared to non-intensive care: a single-center study

PeerJ. 2023 Nov 29:11:e16537. doi: 10.7717/peerj.16537. eCollection 2023.

Abstract

Background: Trisomy 18 syndrome, also known as Edwards syndrome, is a chromosomal trisomy. The syndrome has historically been considered lethal owing to its poor prognosis, and palliative care was primarily indicated for trisomy 18 neonates. Although there have been several reports on the improvement of survival outcomes in infants with trisomy 18 syndrome through neonatal intensive care, few studies have compared the impact of neonatal intensive care on survival outcomes with that of non-intensive care. Therefore, we compared the survival-related outcomes of neonates with trisomy 18 between intensive and non-intensive care.

Methods: Seventeen infants of trisomy 18 admitted to our center between 2007 and 2019 were retrospectively studied. We divided the patients into a non-intensive group (n = 5) and an intensive group (n = 12) and evaluated their perinatal background and survival-related outcomes of the two groups.

Results: The 1- and 3-year survival rates were both 33% in the intensive group, which was significantly higher than that in the non-intensive group (p < 0.001). Half of the infants in the intensive care group were discharged alive, whereas in the non-intensive care group, all died during hospitalization (p = 0.049).

Conclusions: Neonatal intensive care for neonates with 18 trisomy significantly improved not only survival rates but also survival-discharge rates. Our findings would be helpful in providing 18 trisomy neonates with standard neonatal intensive care when discussing medical care with their parents.

Keywords: Neonatal intensive care; Palliative care; Parental autonomy; Survival outcomes; Trisomy 18.

MeSH terms

  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care, Neonatal*
  • Pregnancy
  • Retrospective Studies
  • Survival Rate
  • Trisomy 18 Syndrome / genetics
  • Trisomy* / genetics

Grants and funding

This work was supported by JSPS KAKENHI Grant Number JP21K10494. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.