The neonatal morbidity and mortality of low birth weight neonates

During the period between January 1, 1987 and March 31, 1991, a total of 454 low birth weight neonates, classified if below 2,500 grams, admitted to this hospital, 450 of them could be evaluated retrospectively. Among the 450 cases, 41 (9.1%) were transferred from outside hospitals within 24 hours of birth; and 409 were original hospital inpatients. The sex distribution was quite even (M/F = 227/223), but more than half of them were small-for-date (56.4%). Multiple pregnancy accounted for 22.9%, and toxemic mother, for 11.6%. Neonatal mortality rates were 23.9% for those with birth weight below 1,500, and 45.5% for those with birth weight below 1,000 grams, respectively. Respiratory distress syndrome occurred in 15.9% of the low birth weight neonates, and the incidence increased stepwise as birth weight decreased. Symptomatic patent ductus arteriosus could be detected in 11%. Fundoscopical evaluation, a routine for all with birth weight below 1,500 grams or below 2,000 grams with prolonged ventilator support, demonstrated retinopathy of prematurity in 5.6% of all cases or 50% in those below 1,000 grams. Routine brain echo done in all those below 2,000 grams within the first three days of age, and at least once every week thereafter, revealed intracranial hemorrhage in 10.2%, but only 2.4% belonged to grade III-IV. Respiratory distress syndrome and outborn were the two major determinants affecting the severity and occurrence of intraventricular hemorrhage significantly.(ABSTRACT TRUNCATED AT 250 WORDS)