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Mortality and morbidity in extremely low birth weight (ELBW) infants in a neonatal intensive care unit
Amit Tagare1, Sudha Chaudhari, Sandeep Kadam
1Division of Neonatology, Department of Pediatrics, KEM Hospital, Sardar Moodliar Road, Rasta Peth, Pune, Maharashtra 411011, India.
Insights
Extremely low birth weight (ELBW) babies face high mortality in Neonatal Intensive Care Units (NICUs). Factors like low birth weight and prematurity significantly impact survival rates for these vulnerable infants.
Area of Science:
- Neonatalogy
- Perinatology
- Pediatric Critical Care
Background:
- Extremely low birth weight (ELBW) infants represent a vulnerable population requiring intensive care.
- Understanding morbidity and mortality patterns in ELBW infants is crucial for improving outcomes in Neonatal Intensive Care Units (NICUs).
Purpose of the Study:
- To ascertain the morbidity and mortality rates among ELBW infants admitted to a Neonatal Intensive Care Unit (NICU) until their discharge.
- To identify key factors influencing survival and common morbidities in this high-risk infant population.
Main Methods:
- A prospective observational study was conducted in a Level III NICU over a 17-month period.
- All admitted ELBW infants were monitored for morbidities, required interventions, and survival status.
- Data collection focused on birth weight, gestational age, and specific clinical outcomes.
Main Results:
- The overall survival rate for 87 ELBW infants was 56.1%.
- Leading causes of death included pulmonary hemorrhage (25%), respiratory distress syndrome (RDS) (22.5%), intraventricular hemorrhage (IVH) (22.5%), and sepsis (20%).
- Infants weighing <750 g at birth and with <28 weeks gestation had significantly poorer survival rates (p<0.0001). Common morbidities included RDS (67.8%), probable sepsis (62.1%), and hyperbilirubinemia (59.8%).
Conclusions:
- ELBW infants significantly contribute to NICU mortality.
- Infants with very low birth weight (<750 g) and extreme prematurity (<28 weeks gestation) exhibit poor prognoses.
- RDS, pulmonary hemorrhage, IVH, and sepsis are primary causes of mortality, while RDS, sepsis, and hyperbilirubinemia are prevalent morbidities.
Objective:
To determine the morbidity and mortality in ELBW babies till discharge from a Neonatal Intensive Care Unit (NICU).
Methods:
This study was a prospective observational study conducted in a 40 bed well equipped level III care NICU between 01.12.2006 and 30.04.2008. All ELBW babies admitted during this period were assessed for morbidities and interventions required during NICU stay and for their outcome like survival or death.
Results:
The survival rate of 87 ELBW babies admitted during this period was 56.1 %. Pulmonary hemorrhage was the commonest cause of death (25 %) followed by respiratory distress syndrome (22.5 %), intraventricular hemorrhage (22.5 %) and sepsis (20 %). Significantly higher number of non-survivors were <750 g at birth (p = 0.0001) and <28 wk gestation (p = 0.0001). Small for gestational babies had better chances of survival compared to those appropriate for gestational age (p = 0.005). RDS (67.8 %), probable sepsis (62.1 %) and hyperbilirubinemia (59.8 %) were the most frequent morbidities. Conventional ventilation (72.4 %) and nasal CPAP(48.3 %) were the commonest respiratory interventions. Surfactant replacement therapy was required in 47.1 % babies.
Conclusions:
ELBW babies have a major contribution to mortality in a NICU. Babies with birth weight <750 g and gestation <28 wk have poor survival. RDS, pulmonary hemorrhage, IVH and sepsis are the common causes of death while RDS, sepsis and hyperbilirubinemia are the most common morbidities.
