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Survival and outcome of infants weighing less than 800 grams at birth
E G Lipper1, G S Ross, P A Auld
1Department of Pediatrics, New York Hospital-Cornell University Medical College, NY 10021.
Insights
Extremely low birth weight infants (500-799 gm) face significant risks. Five-minute Apgar score and initial pH predict mortality, with most survivors needing early intervention services.
Area of Science:
- Neonatal research
- Pediatric neurology
- Developmental pediatrics
Background:
- Infants with extremely low birth weights (500-799 gm) have high mortality and morbidity rates.
- Understanding predictive factors for mortality and long-term outcomes is crucial for improving care.
Purpose of the Study:
- To identify maternal and neonatal predictors of mortality in extremely low birth weight infants.
- To assess the neurologic and developmental outcomes of surviving extremely low birth weight infants.
Main Methods:
- Maternal and early neonatal variables were analyzed using stepwise logistic regression.
- Mortality prediction was based on statistical significance (p <= 0.05).
- Surviving infants underwent neurologic and developmental examinations between 17 months and 7 years of age.
Main Results:
- The five-minute Apgar score and initial pH were the sole significant predictors of mortality.
- A substantial majority (72%) of surviving infants exhibited suspect or abnormal neurologic and/or developmental examinations.
- Most survivors required rehabilitation or early intervention services.
Conclusions:
- Five-minute Apgar score and initial pH are critical indicators for predicting mortality in extremely low birth weight infants.
- Long-term neurodevelopmental deficits are common in survivors, necessitating early intervention.
- Improved prenatal and neonatal care strategies are essential for this vulnerable population.
Abstract:
This study reports on two aspects of outcome in a sample of infants whose birth weights ranged from 500 to 799 gm. First, maternal and early neonatal variables were analyzed by means of stepwise logistic regression. Five-minute Apgar score and initial pH were the only variables that predicted mortality at p less than or equal to 0.05. Second, the surviving infants were examined at ages ranging from 17 months to 7 years. The majority (72%) had neurologic and/or developmental examinations in the suspect or abnormal range and required rehabilitation or early intervention services.