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Updated: Mar 8, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Major anomalies and birth-weight influence NICU interventions and mortality in infants with trisomy 13 or 18
K Acharya1, S Leuthner1, R Clark2
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
Insights
Infants with trisomy 13 or 18 (T13/T18) have varying NICU mortality based on birth weight and anomalies. Risk stratification aids family counseling for these complex genetic conditions.
Area of Science:
- Neonatal Medicine
- Genetics
- Pediatric Critical Care
Background:
- Trisomy 13 (T13) and Trisomy 18 (T18) are severe chromosomal abnormalities.
- Outcomes for infants with T13/T18 vary significantly.
- Understanding factors influencing NICU interventions and mortality is crucial.
Purpose of the Study:
- To analyze neonatal intensive care unit (NICU) medical interventions and mortality.
- To stratify outcomes by birth weight and major anomaly types in infants with T13 or T18.
Main Methods:
- Retrospective cohort analysis of 841 infants with T13 or T18 (2005-2012).
- Infants classified into three groups: neonatal surgical, non-neonatal surgical, and minor anomalies.
- Outcomes assessed: NICU interventions and mortality.
Main Results:
- NICU mortality ranged from 70% (<1500g, surgical anomalies) to 31% (≥2500g, minor anomalies).
- Infants ≥1500g without surgical anomalies had the lowest NICU interventions and mortality.
- Birth weight and anomaly type significantly impacted NICU outcomes.
Conclusions:
- Risk stratification by anomaly type and birth weight is essential.
- This approach can improve family counseling accuracy for infants with T13 and T18.
- Tailored management strategies may optimize care for these infants.
Objective:
To describe neonatal intensive care unit (NICU) medical interventions and NICU mortality by birth weight and major anomaly types for infants with trisomy 13 (T13) or 18 (T18).
Study Design:
Retrospective cohort analysis of infants with T13 or T18 from 2005 to 2012 in the Pediatrix Medical Group. We classified infants into three groups by associated anomaly type: neonatal surgical, non-neonatal surgical and minor. Outcomes were NICU medical interventions and mortality.
Results:
841 infants were included from 186 NICUs. NICU mortality varied widely by anomaly type and birth weight, from 70% of infants <1500 g with neonatal surgical anomalies to 31% of infants ⩾2500 g with minor anomalies. Infants ⩾1500 g without a neonatal surgical anomaly comprised 66% of infants admitted to the NICU; they had the lowest rates of NICU medical interventions and NICU mortality.
Conclusions:
Risk stratification by anomaly type and birth weight may help provide more accurate family counseling for infants with T13 and T18.
