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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Prognostic predictors of neurodevelopmental outcome or mortality in very-low-birth-weight infants
Pei-Chyi Chen1, Pei-Wei Wang, Li-Jung Fang
1Department of Pediatrics, Taipei City Hospital, Branch for Women and Children, 12, Fujhou Street, Jhongiheng District, Taipei City 100, Taiwan.
Insights
Survival rates for very-low-birth-weight (VLBW) infants are improving. However, low birth weight and higher intraventricular hemorrhage (IVH) grades significantly predict unfavorable neurodevelopmental outcomes in these vulnerable infants.
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Perinatology
Background:
- Survival rates for very-low-birth-weight (VLBW) infants have improved.
- Neurodevelopmental outcomes remain a primary concern for parents of VLBW infants.
Purpose of the Study:
- To survey survival rates, neurodevelopmental outcomes, and prognostic factors in VLBW infants.
- To identify significant predictors of unfavorable outcomes in VLBW infants.
Main Methods:
- Retrospective study of VLBW infants admitted to Taipei City Hospital (2001-2004).
- Analysis of medical records for 68 VLBW infants.
- Statistical analysis including multiple logistic regression.
Main Results:
- Overall one-year survival rate was 70.3%.
- Low birth weight and higher intraventricular hemorrhage (IVH) grades were significant predictors of unfavorable outcomes.
- Respiratory distress syndrome (RDS) increased risk, while Cesarean section (C/S) decreased the risk of severe IVH.
Conclusions:
- VLBW infant survival rates are comparable to other Taiwanese medical centers.
- Prenatal therapies to prevent RDS and Cesarean section delivery may be optimal strategies to prevent severe IVH and unfavorable outcomes.
Abstract:
Survival rate of very-low-birth-weight (VLBW) infants has much improved in recent years. However, neurodevelopmental outcomes are still of the most concerned to such infants' parents. In order to survey survival rate, neurodevelopmental outcome and prognostic factors in these infants, we did a retrospective study of VLBW infants who were admitted to neonatal intensive care unit of Taipei City Hospital, Branch for Women and Children from 1st January 2001 to 31th October 2004. We reviewed their medical records and analyzed the data. A total of 68 cases were enrolled in this study, and overall one-year survival rate was 70.3% (45/64). The unfavorable outcome group had lower birth weight, lower gestational age, lower Apgar scores at 1-minute and 5-minute, higher rate of vaginal delivery, more respiratory distress syndrome (RDS), and higher IVH grades (all p value < 0.05). However, with multiple logistic regression analysis, only low birth weight and higher IVH grades were the significant predictors of unfavorable outcome. Univariate analysis showed that RDS increased but Cesarean section (C/S) decreased the risk of severe IVH. According to the result, we can make the conclusion that the survival rate of VLBW infants in our hospital was similar to that in other medical centers in Taiwan. In order to prevent severe grades of IVH and subsequent unfavorable outcome in VLBW infants, prenatal therapies to prevent RDS and perhaps choice of C/S as delivery mode are the best strategies.
