Abstract |
Very little data exist describing the neonatal outcome of infants of birthweight 2500 g or more who require mechanical ventilation. Our aim was to collect population-based data on such infants in New South Wales (NSW), and to monitor their neonatal morbidity, mortality to 1 year of age and the associated risk factors. The study group (NICUS infants) comprised all 341 infants weighing > 2499 g who were admitted to the seven neonatal intensive care units in New South Wales and mechanically ventilated for 4 h or more between 1 January and 31 December, 1987. Two groups of infants emerged: those who were preterm and mostly had hyaline membrane disease, and term and post-term infants for whom the most common problem was 'perinatal asphyxia'. The most important factors associated with dying were a birthweight of over 3499 g (OR = 2.6; CI 1.03-6.6) and a 1 min Apgar score < 4 (OR = 4.8; CI 1.4-16.9). Study group mothers were significantly more likely than all NSW mothers to have had a spontaneous abortion in the previous pregnancy (P < 0.01), a pre-existing medical condition or an obstetric complication in this pregnancy, or a Caesarean section for this delivery (P < 0.001). This is the first population-based study of high-risk neonates without congenital anomalies to clearly document the worsening prognosis associated with a birthweight over 3499 g. Further research should be directed towards identifying prenatal and perinatal factors which might minimize the morbidity and mortality in this group of babies.
|
Authors | L Sutton, B Bajuk, B Duffy, I Alexander, J Arnold, G Leslie, D Henderson-Smart, E John, V Roberts, A Berry |
Journal | Journal of paediatrics and child health
(J Paediatr Child Health)
Vol. 29
Issue 6
Pg. 418-23
(Dec 1993)
ISSN: 1034-4810 [Print] Australia |
PMID | 8286156
(Publication Type: Journal Article, Multicenter Study)
|
Topics |
- Apgar Score
- Asphyxia Neonatorum
(epidemiology, mortality, therapy)
- Birth Weight
- Fetal Macrosomia
(mortality)
- Humans
- Hyaline Membrane Disease
(mortality, therapy)
- Infant, Newborn
- Infant, Newborn, Diseases
(mortality, therapy)
- Infant, Premature
- Logistic Models
- Morbidity
- Prospective Studies
- Respiration, Artificial
- Risk Factors
- Seizures
(epidemiology)
|