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Published on: August 25, 2014
Survival and Neurodevelopmental Outcome of Extremely-Low-Birth-Weight Infants at One Year of Age-A Prospective,
K P K N Venkataramana1, Vaanathi Hementha Kumar2, Natarajan Chandra Kumar1
1Department of Neonatology, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, Tamil Nadu, 600034, India.
Insights
Most extremely-low-birth-weight (ELBW) neonates survived NICU care, with 80% showing normal neurodevelopment at 1 year. However, survival rates for the smallest infants require improvement.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Extremely-low-birth-weight (ELBW) neonates face significant survival and neurodevelopmental challenges.
- Optimizing outcomes for ELBW infants is a critical area in neonatal intensive care.
Purpose of the Study:
- To evaluate the survival rates at discharge and neurodevelopmental outcomes at 1 year of corrected age (CA) for ELBW neonates.
- To identify factors influencing survival and neurodevelopment in this vulnerable population.
Main Methods:
- A prospective, descriptive study of 49 ELBW neonates in a tertiary care NICU.
- Follow-up to 1 year CA included anthropometry, Denver Developmental Screening Test (DDST), Amiel-Tison scale, and Developmental Assessment Scale for Indian Infants (DASII).
Main Results:
- Overall survival to discharge was 75.5%.
- Neonates with birth weight >750g or gestational age ≥26 weeks had higher survival rates (90.2% and 85.7%, respectively).
- Among infants <750g or <26 weeks, none survived. 18.1% of infants followed at 1 year CA had abnormal neurodevelopment (DQ <70%).
Conclusions:
- Approximately 75% of ELBW infants survived discharge, and 80% of those followed had normal neurodevelopment at 1 year CA.
- Survival rates for neonates born <26 weeks gestation and/or <750g birth weight were low and need improvement.
- Targeted interventions are necessary to improve outcomes for the most vulnerable ELBW neonates.
Objectives:
To study the survival rates at discharge and neurodevelopmental outcome at 1 y of corrected age (CA) of extremely-low-birth-weight ELBW neonates.
Methods:
This prospective, descriptive study was conducted in a tertiary care level III extramural NICU of a teaching hospital. Forty-nine extremely-low-birth-weight (ELBW) neonates were enrolled in the study from July 2017 to June 2018. Baseline demographic data, morbidities during NICU stay, and survival at discharge for the enrolled neonates were recorded. The enrolled infants were followed up to 1 y of CA at three-monthly intervals. During the follow-up, anthropometry, developmental screening by Denver Developmental Screening Test (DDST), and tone assessment by Amiel-Tison scale were done. Developmental Assessment Scale for Indian Infants (DASII) was administered at CA of 12 mo.
Results:
Thirty-seven (75.5%) neonates survived to discharge. Survival rate of neonates with birth weight > 750 g and with gestational age ≥ 26 wk was 90.2% and 85.7%, respectively. Amongst those < 750 g or < 26 wk (n = 8), none survived. Abnormal developmental quotient (DQ < 70%) was seen in 6 infants out of 33 infants (18.1%) followed at 1 y of CA.
Conclusion:
Overall, 3/4th of ELBW infants survived to discharge and 80% of those who were followed up at 1 y of CA had normal neurodevelopmental outcome. However, survival rates of neonates born at < 26 wk and/or with birth weight < 750 g were less and needs to be improved.
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