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Outcome for very low birth-weight infants
Insights
Outcomes for very low birth weight infants were analyzed. Pulmonary hemorrhage, birth weight, and intraventricular hemorrhage were key predictors of mortality and major handicap in these vulnerable newborns.
Area of Science:
- Neonatalogy
- Pediatric Outcomes Research
- Perinatal Epidemiology
Background:
- Very low birth weight (VLBW) infants face significant risks.
- Understanding factors influencing VLBW infant outcomes is crucial for improving survival and long-term health.
Purpose of the Study:
- To investigate the incidence of VLBW infants and analyze factors predicting mortality and major handicap.
Main Methods:
- Retrospective study of 69 VLBW infants born between 1984-1986.
- Analysis included hospital mortality, follow-up assessments for major/moderate handicap, and stepwise multiple discriminant function analysis.
Main Results:
- Overall hospital mortality was 40.6%.
- Major handicap occurred in 12.5% of survivors.
- Pulmonary hemorrhage, birth weight, intraventricular hemorrhage, and maternal antepartum hemorrhage predicted outcomes with 85.1% accuracy.
Conclusions:
- Pulmonary hemorrhage is the most significant predictor of adverse outcomes in VLBW infants.
- Early identification of risk factors can guide interventions for VLBW neonates.
Abstract:
A total of 69 very low birth weight (VLBW = birth weight less than or equal to 1500gm) infants, born at Veterans General Hospital from January 1, 1984 until December 31, 1986, were studied, excluding 4 patients who were discharged before the condition was stabilized and were also lost to follow-up. The incidence of VLBW infants was 7.5 per thousand of 9214 total live birth deliveries; male to female ratio was 34:39. The hospital mortality rate for babies with birth weight less than 1001gm was 65%; for those with birth weight 1001-1500gm was 30.6%; the total mortality at hospital discharge was 40.6%. The corrected ages at final follow-up assessment ranged from eight months to four years. Among the 41 survivors one case was lost to follow-up. Of the remaining 40 cases, 5 cases had major handicap which was manifested with either severe debilitating morbidity or marked developmental delay; the incidence was 12.5%. One of them died at the postnatal age of 18 months due to ventriculo-peritoneal shunt (V-P shunt) obstruction. Six cases (15.0%) had moderate handicap; the remaining 29 cases (72.5%) were considered to be normal or to suffer from transient, mild, resolvable problems. Cases with mortality or major handicap were categorized into "worse" group, otherwise they belonged to the "better" group. Stepwise multiple discriminant function analysis showed that four factors could correctly classify the outcome in 85.1% of infants: pulmonary hemorrhage was the most important factor followed by birth weight, intraventricular hemorrhage, and maternal antepartum hemorrhage.(ABSTRACT TRUNCATED AT 250 WORDS)