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Survival and morbidity in extremely low birth weight (ELBW) infants
Shankar Narayan1, Rajiv Aggarwal, Amit Upadhyay
1Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India. rajivreema@hotmail.com
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This study on extremely low birth weight neonates found a 48.7% survival rate. Sepsis and immaturity were leading causes of mortality in these vulnerable infants.
Area of Science:
- Neonatalogy
- Pediatric Critical Care
- Perinatology
Background:
- Extremely low birth weight (ELBW) neonates represent a vulnerable population with significant morbidity and mortality.
- Tertiary care centers manage a substantial number of these high-risk infants.
Purpose of the Study:
- To analyze the morbidity and mortality patterns of extremely low birth weight neonates managed over a seven-year period.
- To identify factors associated with mortality in ELBW infants.
Main Methods:
- Retrospective review of medical records for ELBW infants born between 1994 and 2000.
- Data collection included maternal and neonatal details, clinical management, and outcomes.
- Statistical analysis to determine associations between clinical factors and mortality.
Main Results:
- Out of 12,807 live births, 137 (1.07%) were ELBW infants, with a 48.7% survival rate.
- Common morbidities included hyperbilirubinemia (65%), respiratory distress (65%), and sepsis (52%).
- Sepsis (41%) and immaturity (24%) were the primary causes of death; resuscitation, pulmonary hemorrhage, and seizures were linked to mortality.
Conclusions:
- ELBW infants face substantial risks, with sepsis being a major contributor to mortality.
- Effective management strategies are crucial for improving survival rates in this population.
- Further research into preventing and treating common morbidities is warranted.
Abstract:
We report the morbidity and mortality in extremely low birth weight neonates (ELBW) from a tertiary care hospital over seven years (1994-2000). Data regarding maternal and neonatal details was obtained from old records, computer database and medical files. Of the 12,807 live births during this period, 137 (1.07%) were ELBW infants. All of them were managed without surfactant. Overall, 67 infants (48.7%) survived to discharge. The most commonly encountered morbidities were hyperbilirubinemia(65%), respiratory distress(65%), sepsis(52%), intraventricular hemorrhage(29%), pneumonia (25%) and retinopathy of prematurity(24%). Need for resuscitation, pulmonary hemorrhage, seizures, acute renal failure, sclerema and air leak syndromes were significantly associated with mortality. Sepsis accounted for 41% of all deaths while immaturity was the second most important cause, accounting for 24% deaths. The average length of stay for survivors was 49 days (SD +/- 15.9 days)