Mortality and neonatal morbidity among infants 501 to 1500 grams from 2000 to 2009
Jeffrey D Horbar1, Joseph H Carpenter, Gary J Badger
1Department of Pediatrics, University of Vermont, Burlington, Vermont 05401, USA. horbar@vtoxford.org
Insights
Mortality and major neonatal morbidity decreased for very low birth weight infants between 2000 and 2009. However, many infants still faced significant health challenges or death by the decade's end.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Public Health
Background:
- Infants born with very low birth weight (501 to 1500 g) face significant risks of mortality and neonatal morbidities.
- Changes in care practices and outcomes for this vulnerable population require ongoing evaluation.
Purpose of the Study:
- To analyze trends in mortality and major neonatal morbidities for infants weighing 501 to 1500 g from 2000 to 2009.
- To assess the impact of medical advancements on outcomes for very low birth weight infants over a decade.
Main Methods:
- A retrospective analysis of 355,806 infants weighing 501 to 1500 g born between 2000 and 2009.
- Data collected from 669 North American hospitals in the Vermont Oxford Network, assessing mortality and major neonatal morbidities in survivors.
Main Results:
- Overall mortality for infants weighing 501 to 1500 g decreased from 14.3% to 12.4% between 2000 and 2009.
- Major morbidity in survivors also declined, from 46.4% to 41.4% during the same period.
- In 2009, mortality varied significantly by birth weight, and nearly half of all very low birth weight infants either died or had major morbidities.
Conclusions:
- Significant improvements in reducing mortality and major neonatal morbidity were observed for very low birth weight infants from 2000 to 2009.
- Despite these advances, a substantial proportion of these infants continued to experience severe health issues or mortality, highlighting the need for continued research and improved interventions.
Objective:
To identify changes in mortality and neonatal morbidities for infants with birth weight 501 to 1500 g born from 2000 to 2009.
Methods:
There were 355806 infants weighing 501 to 1500 g who were born in 2000-2009. Mortality during initial hospitalization and major neonatal morbidity in survivors (early and late infection, chronic lung disease, necrotizing enterocolitis, severe retinopathy of prematurity, severe intraventricular hemorrhage, and periventricular leukomalacia) were assessed by using data from 669 North American hospitals in the Vermont Oxford Network.
Results:
From 2000 to 2009, mortality for infants weighing 501 to 1500 g decreased from 14.3% to 12.4% (difference, -1.9%; 95% confidence interval, -2.3% to -1.5%). Major morbidity in survivors decreased from 46.4% to 41.4% (difference, -4.9%; 95% confidence interval, -5.6% to -4.2%). In 2009, mortality ranged from 36.6% for infants 501 to 750 g to 3.5% for infants 1251 to 1500 g, whereas major morbidity in survivors ranged from 82.7% to 18.7%. In 2009, 49.2% of all very low birth weight infants and 89.2% of infants 501 to 750 g either died or survived with a major neonatal morbidity.
Conclusions:
Mortality and major neonatal morbidity in survivors decreased for infants with birth weight 501 to 1500 g between 2000 and 2009. However, at the end of the decade, a high proportion of these infants still either died or survived after experiencing ≥ 1 major neonatal morbidity known to be associated with both short- and long-term adverse consequences.
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