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Outcomes of extremely low-birth-weight infants between 500 and 750 g
L A Agustines1, Y G Lin, P J Rumney
1Department of Obstetrics and Gynecology, Perinatal Associates, Long Beach Memorial Medical Center, CA 90801, USA.
Insights
Extremely low-birth-weight infants (500-750 g) face significant mortality and developmental delays. Survival is linked to factors like gestational age and medical interventions such as surfactant therapy.
Area of Science:
- Neonatalogy
- Perinatology
- Developmental Pediatrics
Background:
- Extremely low-birth-weight (ELBW) infants, defined as those weighing 500-750 grams, represent a vulnerable population with high risks.
- Understanding the outcomes for this group is crucial for improving neonatal care and long-term developmental support.
Purpose of the Study:
- To characterize the morbidity, mortality, and developmental trajectories of ELBW infants.
- To identify factors associated with survival and long-term neurodevelopmental outcomes in this cohort.
Main Methods:
- Retrospective cohort study of 167 live-born infants.
- Data collected from Long Beach Memorial Medical Center between 1990 and 1995.
- Developmental outcomes assessed using Bayley Scales of Infant Development at 30 months corrected age.
Main Results:
- High mortality rates observed, particularly in infants <600g (86%) versus those >=600g (44%).
- Survival correlated with absence of chorioamnionitis and use of antepartum corticosteroids and neonatal surfactant.
- Significant rates of respiratory distress syndrome (64%) and severe intraventricular hemorrhage (17%) were noted.
- Among survivors, substantial rates of developmental delay were found: 68% on Mental Development Index and 58% on Psychomotor Development Index.
Conclusions:
- ELBW infants exhibit significant morbidity, mortality, and developmental delays.
- Early medical interventions and management of conditions like chorioamnionitis are critical for improving outcomes.
- Long-term neurodevelopmental surveillance is essential for this high-risk population.
Objective:
The purpose of this study was to describe morbidity, mortality, and developmental outcomes among extremely low-birth-weight infants (500-750 g).
Study Design:
This retrospective cohort study included 167 live-born infants born at Long Beach Memorial Medical Center between January 1990 and December 1995.
Results:
Mortality rates were 86% among infants <600 g and 44% among those > or =600 g, and the rate decreased with increasing gestational age. The absence of chorioamnionitis (P =.01) and the use of antepartum corticosteroids (P <.0001) or neonatal surfactant (P =.0001) were associated with survival. Sixty-four percent of studied infants had respiratory distress syndrome, and 17% had grade III or IV intraventricular hemorrhage. Among the 63 survivors 57% were tested at 30 months of corrected age with the Bayley Scales of Infant Development. Mild or significant delays were seen on the mental development index in 68% of these cases and on the psychomotor development index in 58% of cases.
Conclusion:
Morbidity and mortality rates and the rate of developmental delay among infants with birth weights between 500 and 750 g were significant.