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Survival of low-birth-weight infants at Baragwanath Hospital--1950-1996
P A Cooper1, H Saloojee, K D Bolton
1Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg.
Insights
Survival rates for low-birth-weight (LBW) infants significantly improved from 1950 to 1996. Enhanced general care, not just advanced interventions, drove these dramatic increases in LBW infant survival.
Area of Science:
- Neonatalogy
- Pediatric Survival Rates
- Public Health Interventions
Background:
- Low-birth-weight (LBW) infants face higher mortality risks.
- Historical survival rates for LBW infants in tertiary care settings require examination.
- Understanding trends in LBW infant survival is crucial for improving neonatal care.
Purpose of the Study:
- To analyze the changes in survival rates for low-birth-weight infants.
- To assess the impact of medical advancements and general care improvements on LBW infant survival.
- To provide a historical perspective on LBW infant outcomes at Baragwanath Hospital.
Main Methods:
- Retrospective analysis of survival data for LBW infants.
- Data collected from Baragwanath Hospital, a tertiary care center in Soweto, Johannesburg.
- Analysis covered four periods spanning from the 1950s to 1996.
Main Results:
- Overall mortality rates for LBW infants decreased significantly between the 1950s and 1995/96.
- By the mid-1990s, approximately four times more infants with birth weight <1,500g survived compared to the early 1950s.
- Survival rates for infants weighing 1,000-1,499g increased from 64% to 79%, and for those <1,000g from 14% to 32% between 1981/82 and 1995/96.
Conclusions:
- Dramatic improvements in LBW infant survival were observed at Baragwanath Hospital from the 1950s to the 1990s.
- While advanced interventions like mechanical ventilation contributed, improvements in general care were of major importance.
- The study highlights the critical role of enhanced primary and secondary care in improving neonatal outcomes for LBW infants.
Objectives:
To examine changes in survival rates among low-birth-weight (LBW) infants between the years 1950 and 1996.
Methods:
Survival figures were analysed for LBW infants managed at Baragwanath Hospital, a tertiary care centre in Soweto, Johannesburg, over four periods spanning five decades.
Results:
The overall mortality rates of LBW infants decreased markedly between the early 1950s and the period 1995/96. By the mid-1990's approximately four times the number of infants with birth weight less than 1,500 g were surviving compared with the early 1950s. The reduction in mortality rates occurred in all LBW groups during the first three decades. However, since 1981 infants who weighed less than 1,500 g at birth were the major contributors to the overall reduction in mortality. Between the years 1981/82 and 1995/96, survival increased significantly from 64% to 79% for infants with birth weight 1,000-1,499 g, and from 14% to 32% for those with birth weight less than 1,000 g. Since infants in the latter group were seldom offered mechanical ventilation or artificial surfactant, a large part of these increases in survival can be attributed to improvement in the general level of care.
Conclusion:
There have been dramatic improvements in the survival of LBW infants over this time period at Baragwanath Hospital. Although newer interventions such as mechanical ventilation and artificial surfactant have played a significant role, improvement in care at primary and secondary levels has been of major importance.