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Grand Rounds: The Moving Threshold of Neonatal Viability


By Laura Jackson, MD , Neonatologist, Akron Children's Hospital, Akron, OH

Neonatal and Perinatal Medicine

More about Laura Jackson, MD, FAAP

Objectives (Educational Content) :

1. Summarize the historic and current trends of the recognized threshold of neonatal viability. 2. Understand the importance of the shared decision-making model in determining goals of care for extremely preterm infants. 3. Describe the latest morbidity and mortality data for infants born at an extremely preterm gestational age and understand the post-NICU care that surviving infants require.

Target Audience:

General pediatricians, family physicians, nurse practitioners, physician assistants, social workers, psychologists, and nurses.

Identified Gap:

Recommendations on the approach to resuscitation of extremely premature infants has evolved with advances in the care of those infants at the threshold of viability. It is important for pediatricians to be aware of the current recommendations regarding perinatal management of extreme prematurity.

Estimated Time to Complete the Educational Activity:

1 hour(s)

Expiration Date for CE/CME Credit:


Method of Participation in the Learning Process:

The learner will view the presentation, successfully complete a post-test and complete an activity evaluation.

Evaluation Methods:

All learners must successfully complete a post-test, as well as an activity evaluation, to claim CE/CME credit.


The following presenters have identified that they have no financial relationships with any ineligible companies. Laura Jackson, MD The following CME Committee/Planning Committee member(s) has the following relevant financial relationships with ineligible companies to disclose: Merk Maria Victorio, MD All relationships have been mitigated.

Accreditation Statement:

Children’s Hospital Medical Center of Akron is accredited by the Ohio State Medical Association to provide continuing medical education for physicians.

CHMCA designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit TM.  Physicians should only claim the credit commensurate with the extent of their participation in the activity.


American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine. Obstetric care consensus No. 3: Summary: Periviable birth. Obstet Gynecol. 2015, 126, 1123-5.

American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine. Obstetric Care consensus No. 6: Periviable Birth. Obstet Gynecol. 2017, 130, e187–e199.

Ancel PY, et al. EPIPAGE-2 Writing Group. Survival and morbidity of preterm children born at 22 through 34 weeks' gestation in France in 2011: results of the EPIPAGE-2 cohort study. JAMA Pediatr. 2015, 169, 230-8.

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