An epidemiologic study of very low and very very low birth weight infants

VVLBW infants constitute only 1 per cent of the total births, but account for 60 per cent of the NMR and 40 per cent of the IMR. While improved technology and refinements in care continue to improve survival for VVLBW infants, questions regarding the lower limits of viability must be considered. The medical community can rightly take credit for improvement in outcome of infants with weight and gestations so small that, just a decade ago, they were considered nonviable; however, an excruciatingly slow pace of decline in the prematurity rate is an agonizing fact. Can anything be done to prevent prematurity and avoid its devastating consequences on the family and society? The recent French experience suggests the answer could be "yes." A similar experience also has been reported in the United States. Although VLBW NMR is a major fraction of total IMR, nearly one quarter of first-year deaths occur in infants who are over 2500 gm at birth. That the postneonatal death of normal birth weight infants is only next in magnitude to the neonatal death of VLBW infants further points to the need for developing preventive child health programs encompassing periods before and during the pregnancy, through the immediate peripartum period, and well into infancy and childhood. Neither a woman's pregnancy experience nor the concerns of the health community end with her taking a baby home.