Abstract | BACKGROUND: Improvement in perinatal and neonatal care has resulted in increased survival of extremely low birth weight (ELBW) infants. OBJECTIVES: To describe survival and neonatal morbidity in a cohort of ELBW infants, to compare two consecutive 5-year periods, and compare appropriate (AGA) with small for gestational age (SGA) infants (AGA ≥p10, and SGA <p10). METHODS: Retrospective cohort study of 179 live-born infants with a birth weight (BW) of ≤750 g and gestation of ≥24 weeks, born in 1996-2000 (cohort I, n = 94) and 2001-2005 (cohort II, n = 85) in the Wilhelmina Children's Hospital Utrecht, the Netherlands. RESULTS: During NICU stay (n = 146) 62.3% experienced infant respiratory distress syndrome (IRDS), 46.6% bronchopulmonary dysplasia, 50.7% septicemia, 34.2% periventricular leukomalacia grade I and 24.7% intraventricular hemorrhage grade I/II. IRDS grade III/IV occurred significantly more often in cohort I (p = 0.042), whereas septicemia and hyperbilirubinemia occurred more in cohort II (p = 0.045 and p = 0.001). In AGA infants mean gestation was significantly shorter (p < 0.001), and IRDS grade III/IV (p = 0.015), mechanical ventilation (p = 0.045) and patent ductus arteriosus (p = 0.003) were significantly more prevalent. Overall survival was 62%, and survival in the NICU increased from 65.8% (cohort I) to 88.1% (cohort II, p = 0.002). Survival of AGA and SGA infants did not differ, but increased with time (71.4 to 75.9% and 61.4 to 97.4%, respectively). CONCLUSIONS: Mortality of infants with a BW of ≤750 g is high, but decreased over time, especially in SGA infants. Considerable neonatal morbidity was present, especially in AGA infants, most likely due to their significantly shorter gestation.
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Authors | M J Claas, H W Bruinse, M van der Heide-Jalving, J U M Termote, L S de Vries |
Journal | Neonatology
(Neonatology)
Vol. 98
Issue 3
Pg. 278-88
( 2010)
ISSN: 1661-7819 [Electronic] Switzerland |
PMID | 20453522
(Publication Type: Comparative Study, Journal Article)
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Copyright | Copyright © 2010 S. Karger AG, Basel. |
Topics |
- Adult
- Algorithms
- Birth Weight
(physiology)
- Cohort Studies
- Female
- Gestational Age
- Humans
- Infant Mortality
- Infant, Extremely Low Birth Weight
- Infant, Newborn
- Infant, Premature, Diseases
(epidemiology, mortality)
- Infant, Small for Gestational Age
- Intensive Care, Neonatal
(statistics & numerical data)
- Morbidity
- Pregnancy
- Retrospective Studies
- Survival Analysis
- Young Adult
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