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Improvement of outcome for infants of birth weight under 1000 g. The Victorian Infant Collaborative Study Group
Insights
Survival rates for extremely low birth-weight (ELBW) infants improved significantly between two eras, with a notable reduction in neurological disabilities. This indicates advancements in neonatal care for high-risk newborns.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Public Health
Background:
- Extremely low birth-weight (ELBW) infants face significant mortality and morbidity risks.
- Outcomes for ELBW infants born outside specialized centers were historically worse.
Purpose of the Study:
- To compare the two-year outcomes of ELBW infants across two distinct birth eras.
- To assess changes in survival rates and neurological disabilities among ELBW survivors.
Main Methods:
- Retrospective cohort study comparing ELBW infants born in Victoria during 1979-1980 and 1985-1987.
- Analysis of survival to two years and presence of neurological disabilities.
Main Results:
- Two-year survival for ELBW infants increased from 25.4% to 37.9% between the eras.
- The proportion of ELBW survivors with no neurological disabilities rose from 12.5% to 26.2%.
- Despite improved survival, the absolute number of severely disabled survivors remained constant.
Conclusions:
- Significant improvements in ELBW infant survival and reduced neurological morbidity were observed.
- While specialized center care improved outcomes, disparities persisted for infants born outside these centers.
Abstract:
The two year outcome of extremely low birth-weight (ELBW) infants (birth weight 500 to 999 g), born in the state of Victoria over two distinct eras, 1979-80 and 1985-7, were compared. In the 1979-80 era, 25.4% of the ELBW infants survived to 2 years of age; only 12.5% of liveborn ELBW infants survived to 2 years with no neurological disabilities. In the 1979-80 era, ELBW infants born outside the level III centres in the state were significantly disadvantaged in both mortality and neurological morbidity. By 1985-7, the two year survival rate of ELBW infants rose significantly from 25.4% to 37.9%. By 1985-7, the proportion of ELBW infants who survived to 2 years free of neurological disabilities increased from 12.5% to 26.2%. Despite the improved survival, the absolute number of 2 year old children survivors with severe neurological disabilities remained constant at 8/year in both eras. By 1985-7, fewer ELBW infants were born outside the level III centres, their survival rate remained lower, but the severe neurological disability rate in survivors was no longer significantly higher. There has been a concomitant improvement in both survival and reduction in neurological morbidity.