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Changes in Mortality and Cerebral Palsy in Extremely Low-Birth-Weight Infants in a Tertiary Center in Hong Kong
Yuet Yee Chee1, Rosanna Ming Sum Wong1, Mabel Siu Chun Wong1
1The University of Hong Kong, Hong Kong.
Insights
Survival rates and neurodevelopmental outcomes for extremely low-birth-weight (ELBW) infants have improved over time. This study found higher survival and lower rates of cerebral palsy in recent years compared to earlier periods.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Public Health
Background:
- Extremely low-birth-weight (ELBW) infants face significant survival and neurodevelopmental challenges.
- Temporal trends in outcomes for ELBW infants require ongoing investigation.
Purpose of the Study:
- To investigate time trends in survival and short-term neurodevelopmental outcomes for ELBW infants.
- To compare outcomes from 2008-2015 with a previous cohort (1993-2002).
Main Methods:
- Retrospective review of ELBW infants born at Queen Mary Hospital (2008-2015).
- Analysis of risk factors using Cox regression and logistic regression.
- Comparison with a historical cohort (1993-2002).
Main Results:
- Overall survival rate increased significantly from 71.4% (1993-2002) to 81.1% (2008-2015).
- Rate of cerebral palsy decreased significantly from 13.5% (1993-2002) to 4.2% (2008-2015).
- 81% of survivors were assessed at a mean corrected age of 18.1 months.
Conclusions:
- There has been a temporal improvement in survival rates for ELBW infants.
- Short-term neurodevelopmental outcomes, specifically cerebral palsy, have also improved.
Abstract:
Introduction. We retrospectively reviewed a cohort of extremely low-birth-weight (ELBW) babies born at Queen Mary Hospital and explored if there is any time trend in survival and short-term neurodevelopmental outcomes. Methods. We included ELBW infants born at Queen Mary Hospital between 2008 and 2015. The relationships between multiple risk factors with survival and neurodevelopmental outcomes were analyzed by either Cox regression or univariate logistic regression analysis. We also compared this birth-year period with our previous study from 1993 to 2002. Results. Two hundred seventeen ELBW infants were delivered during the study period. There was significantly higher overall survival rate (81.1%) in 2008 to 2015 compared with 71.4% in 1993 to 2002. One hundred forty-three out of 176 (81%) survivors were assessed at a corrected mean age of 18.1 months. A total of 4.2% had cerebral palsy. There were significantly lower rates of cerebral palsy in 2008 to 2015 (4.2%) compared with 1993 to 2002 (13.5%). Conclusions. We showed a temporal improvement in survival and short-term neurodevelopmental outcomes.
