Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study
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Published on: January 29, 2018
Hui-Jia Lin, Li-Zhong Du1, Xiao-Lu Ma
1Department of Neonatal Intensive Care Unit, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310053, China.
Insights
The survival rate for extremely low birth weight (ELBW) infants in China was 50%, with high mortality and morbidity. Key risk factors included low birth weight and gestational age, while being small for gestational age was protective.
Area of Science:
- Neonatal Medicine
- Perinatal Outcomes
- Public Health
Background:
- Advances in perinatal medicine and neonatal technology increase survival rates for extremely low birth weight (ELBW) infants globally.
- This study addresses the short-term outcomes of ELBW infants within China's Neonatal Intensive Care Units (NICUs).
Purpose of the Study:
- To investigate the short-term outcomes of extremely low birth weight (ELBW) infants during their Neonatal Intensive Care Unit (NICU) stay in mainland China.
- To identify risk factors and common complications affecting ELBW infants in this region.
Main Methods:
- Retrospective data collection from 26 NICUs in mainland China between January 1, 2011, and December 31, 2011.
- Inclusion criteria: infants with birth weight (BW) < 1000 g.
- Statistical analysis included Pearson Chi-square test and Binary Logistic regression to identify risk factors.
Main Results:
- A total of 258 ELBW infants (mean GA 28.1 weeks, mean BW 868 g) were analyzed.
- The overall survival rate at discharge was 50.0%, with 23.3% mortality and 26.7% deaths after care withdrawal.
- Higher survival rates were observed in coastal areas (53.6%) versus inland areas (35.3%). BW < 750 g and GA < 28 weeks were significant risk factors, while being small for gestational age was protective.
- Respiratory distress syndrome was the most common complication. Bronchopulmonary dysplasia (48.1%) and retinopathy of prematurity (41.4%) were highly prevalent. Ventilator-associated pneumonia was the most common hospital-acquired infection.
Conclusions:
- This study provides the first comprehensive overview of ELBW infant status in mainland China.
- Mortality and morbidity rates for ELBW infants in China remain high compared to developed nations.
- Targeted interventions and improved care strategies are crucial for reducing adverse outcomes in this vulnerable population.
Background:
With the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW) survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU) stay in the mainland of China.
Methods:
All infants admitted to 26 NICUs with a birth weight (BW) < l000 g were included between January l, 2011 and December 31, 2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors.
Results:
A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age (GA) was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3%) died and another 69 infants (26.7%) died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019). BW < 750 g and GA < 28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization.
Conclusions:
Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.
