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Birth weight and hospital admission before the age of 2 years
L Mutch1, H Ashurst, A Macfarlane
1National Perinatal Epidemiology Unit, Radcliffe Infirmary, Oxford.
Insights
Neonatal survival rates for very low birthweight infants (weighing 1500 g or less) significantly improved, but their hospital admission rates also increased. Continued monitoring of these vulnerable infants is recommended.
Area of Science:
- Pediatrics
- Neonatalogy
- Public Health
Background:
- Infant survival and hospitalization rates are key indicators of healthcare quality.
- Trends in outcomes for infants with very low birth weight (VLBW) require ongoing evaluation.
Purpose of the Study:
- To compare hospital admission rates between infants born weighing 1500 g or less and those born weighing over 1500 g.
- To analyze trends in neonatal survival and childhood hospital admissions for these groups over three decades.
Main Methods:
- Retrospective analysis of routinely collected data from the Oxford Record Linkage Study.
- Inclusion of births from Oxfordshire and West Berkshire across 1968-72, 1974-8, and 1979-83.
- Primary outcome measures: survival to 28 days and hospital admissions up to age two years.
Main Results:
- Neonatal survival for infants weighing 1500 g or less increased from 350.2 to 577.4 per 1000 births between 1968-72 and 1979-83.
- Hospital admissions for survivors weighing 1500 g or less rose from 218.6 to 444.4 per 1000 by age two.
- For infants over 1500 g, survival improved slightly (985.5 to 995.9 per 1000) and admissions increased (98.2 to 144.4 per 1000).
Conclusions:
- While VLBW infants had improved survival, their increased hospitalization necessitates monitoring.
- Despite small numbers, VLBW infants' contribution to hospital bed occupancy grew over time.
- Continuous monitoring of VLBW infants' outcomes using routine systems is essential.
Abstract:
Admission rates to hospital of children born weighing 1500 g or less were compared with those born with birth weights over 1500 g in a retrospective analysis of routinely collected data from the Oxford Record Linkage Study. The children were born in the three five year periods 1968-72, 1974-8, and 1979-83 to women resident in Oxfordshire and West Berkshire. The main measures of the study were survival rates to 28 days after birth and hospital admissions of survivors up to the age of two years. Among babies weighing 1500 g or less, neonatal survival rates rose from 350.2 per 1000 total births in 1968-72 to 577.4 per 1000 among births in 1979-83. Over the same period, the proportion of children admitted to hospital at least once before the age of 2 years rose from 218.6 per 1000 survivors to 444.4 per 1000. In the children with birth weights over 1500 g, survival rates rose from 985.5 to 995.9 per 1000 births and hospital admission rates rose from 98.2 to 144.4 per 1000 survivors over the same time period. Although very low birthweight children did not contribute significantly to total hospital bed occupancy, because their numbers were small in relation to the total number of children in the population, their contribution increased between the five year periods 1968-72 and 1979-83. It should therefore be continuously monitored using routine systems.