Can the special care neonatal unit admission cut-off be lowered down to 1500g babies?

The study was conducted to find out whether there is any significant difference in outcome if low birth weight babies weighing between 1500g and 1800g are managed by keeping them with their mothers, i.e., without special care neonatal unit (SCNU) admission.

It was a retrospective study for which data was collected from past medical record section of 6 months duration from 01.07.06 to 31.12.06, Medical College, Kolkata. The subject of the study was babies born with weight between 1500g and 2000g, divided into 2 groups. Group A representing babies born between weight 1500g and 1800g, groups B representing babies born between 1801g and 2000g. The groups were compared with regard to four variable namely average material age, sex of the babies, singleton or twin pregnancy, mode of delivery and gestational maturity. Test of one proportion was used for statistical analysis of outcome.

Total number of live born babies in group A were 198 and in group B 223. Two group were comparable with respect to average maternal age (23.7 yr), sex distribution, singleton or twin pregnancy and number of cesarian section or vaginal delivery and proportion of small for gestational age (SGA) babies. In both the group 13 babies required SCNU admission after being given to their mothers in the postnatal ward. No significant difference in outcome was observed between the groups.

We conclude that the recommended guidelines for giving institutional care to babies below 1800g may be lowered down to 1500g. However, more babies should be evaluated prospectively, over a longer duration of time, before changing the standard guidelines.