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Increasing survival of extremely low birthweight infants in Alaska
Insights
Survival rates for extremely premature infants (500-750g) significantly improved from 1987 to 1989 due to enhanced perinatal and neonatal care practices. This study highlights advancements in treating very low birthweight infants.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Pediatric Intensive Care
Background:
- Extremely premature infants (birthweight 500-750g) have historically faced low survival rates.
- Improvements in neonatal intensive care unit (NICU) practices are crucial for this vulnerable population.
- Understanding factors influencing survival is essential for optimizing care.
Purpose of the Study:
- To analyze survival rates and characteristics of extremely premature infants treated between 1987-1989.
- To identify changes in perinatal and neonatal factors contributing to survival.
- To compare outcomes between survivors and non-survivors.
Main Methods:
- Retrospective review of 40 extremely premature infants (500-750g) admitted to Providence Hospital NICU.
- Analysis of survival trends from 1987 to 1989.
- Statistical comparison of perinatal/neonatal factors and stepwise regression analysis.
Main Results:
- Overall survival increased dramatically: 21% (1987), 47% (1988), 82% (1989).
- Significant increases in chorioamnionitis and birthweight observed over the study period.
- Survival improved even without considering artificial surfactant use in 1989 (21% to 75%).
Conclusions:
- Multiple changes in obstetrical and pediatric practices led to increased survival for extremely low birthweight infants in Alaska.
- Continued advancements in care are vital for improving outcomes in this high-risk group.
- Further research into neurodevelopmental outcomes is warranted.
Abstract:
The survival and characteristics of extremely premature infants with a birthweight between 500 and 750 grams, who were treated at Providence Hospital newborn intensive care unit, were reviewed over the years 1987 to 1989. Forty infants were admitted and treated. Survival increased from 21 percent in 1987, 47 percent in 1988 to 82 percent in 1989. Changes in perinatal and neonatal factors over the three years were reviewed and comparisons between survivors and non-survivors were analyzed. Stepwise regression analysis revealed significant increases in the incidence of chorioamnionitis and birthweight over the period. Increased survival was noted even when infants from 1989, who received artificial surfactant, were excluded (survival increased from 21 percent in 1987 to 75 percent in 1989). Recent literature on extremely low birthweight infants, including neurodevelopmental outcome, is reviewed. Survival of extremely low birthweight infants in Alaska is increasing because of multiple changes in obstetrical and pediatric practices.
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