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[Predictive factors of mortality in extremely preterm infants]

L Lin1, M C Fang, H Jiang

  • 1Department of Neonatology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, China.

Zhonghua Er Ke Za Zhi = Chinese Journal of Pediatrics
|April 4, 2018
PubMed

Insights

Extremely preterm infants born before 25 weeks gestational age (GA) face higher mortality. Factors like low birth weight, necrotizing enterocolitis, and mechanical ventilation increase risk, while intraventricular hemorrhage may be protective.

Area of Science:

  • Neonatal Medicine
  • Pediatric Critical Care
  • Perinatology

Background:

  • Extremely preterm infants (born <29 weeks gestational age) have high mortality rates.
  • Identifying predictive factors for mortality is crucial for improving outcomes in this vulnerable population.

Purpose of the Study:

  • To investigate factors predicting mortality in extremely preterm infants.
  • To compare mortality trends and predictive factors between two distinct time periods.

Main Methods:

  • Retrospective case-control study of 268 extremely preterm infants.
  • Univariate and multivariate logistic regression analyses were used to identify predictive factors.
  • Comparison of mortality between 1999-2007 and 2008-2015.

Main Results:

  • Mortality was significantly higher in infants with gestational age (GA) <25 weeks.
  • From 2008-2015, infant numbers increased, but mortality significantly decreased compared to 1999-2007.
  • Predictive factors for mortality included GA <25 weeks, lower birth weight, stage III necrotizing enterocolitis (NEC), and invasive mechanical ventilation dependence.
  • Grade I and II intraventricular hemorrhage (IVH) was found to be a protective factor.

Conclusions:

  • Gestational age below 25 weeks, low birth weight, stage III NEC, and reliance on invasive mechanical ventilation are significant risk factors for mortality in extremely preterm infants.
  • Grade I and II intraventricular hemorrhage appears to have a protective effect on mortality in this population.

Keywords:
Cause of deathInfant, premature, diseasesPrognosis

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