Considerable mortality and morbidity in neonates born below 500 gram

Area of Science:

• Neonatalogy
• Perinatal Medicine
• Developmental Pediatrics

Background:

• Data on mortality and morbidity in infants born weighing ≤500 grams are limited and highly variable.
• Accurate neurodevelopmental outcome data is crucial for parental counseling and clinical decision-making for extremely low birth weight infants.

Purpose of the Study:

• To analyze the neurodevelopmental outcomes of all neonates born weighing ≤500 grams.
• To provide data supporting counseling and decision-making for extremely preterm infants.

Main Methods:

• Retrospective analysis of preterm infants with birth weight ≤500 grams and gestational age >22 weeks.
• Infants born between 2010 and 2017 at a single tertiary perinatal center were included.
• Neurodevelopmental outcome assessed at two years using Bayley Scales of Infant Development, visual/hearing assessments, and Gross Motor Function Classification System (GMFCS).

Main Results:

• Survival rate was 37% for all live births and 42% for infants receiving standard care.
• Neurodevelopmental outcome data was available for 91% of patients.
• At two years, 50% had favorable mental development, 75% favorable motor development, and 45% favorable outcomes in both categories.
• 35% had a good neurodevelopmental outcome when considering visual/hearing impairments and cerebral palsy (GMFCS level ≥2).
• Over one-third of survivors exhibited no significant neurodevelopmental impairment.

Conclusions:

• A significant proportion of survivors born weighing ≤500 grams demonstrate favorable neurodevelopmental outcomes at two years.
• These findings can aid in providing more accurate prognoses and counseling for parents of extremely preterm infants.
• Further research is warranted to improve survival and long-term outcomes for this vulnerable population.