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Published on: November 20, 2015
[Outcome of 404 premature infants born before 32 weeks of gestation in 1978-1980]
Insights
Gestational age is crucial for predicting outcomes in premature infants. This study of 404 neonates born before 32 weeks highlights risks of death and handicap, emphasizing gestational age and birth weight analysis for better infant care.
Area of Science:
- Neonatalogy and Perinatology
- Pediatric Outcomes Research
- Gestational Age Assessment
Context:
- Study cohort: 404 premature infants born before 32 weeks gestation, admitted to Institut de Puériculture (IP) in 1978-1980.
- Data collected on post-menstrual age and birth weight.
- Follow-up included survival rates and developmental assessments at 2 years.
Purpose:
- To analyze the outcome of premature infants based on gestational age and birth weight.
- To determine risks of mortality and handicap in relation to gestational age categories.
- To evaluate the predictive value of gestational age for infant outcomes.
Summary:
- Overall mortality during hospitalization was 20.5%. Among survivors, 71% were followed to at least 2 years, with 3.1% experiencing unexpected home death.
- An 8% handicap rate (cerebral palsy, psychomotor deficiency) was observed in survivors. Other issues included strabismus and psychosocial disturbances.
- Infants born <28 weeks faced higher risks: 47% mortality, 3% handicap, 47% normal survival. Risks decreased with advancing gestational age (28-29.9 wks, 30-31.9 wks).
Impact:
- Gestational age is a significant predictor of mortality and handicap in premature infants.
- Analysis by gestational age and birth weight improves outcome estimation for high-risk neonates.
- Findings underscore the importance of tailored neonatal care strategies based on gestational maturity.
Abstract:
The outcome of 404 prematures born before 32 weeks of gestation and admitted on the first day of life to the Institut de Puériculture (IP) in 1978-1980 was studied with respect to post-menstrual age and birth weight: 83 (20,5%) died during the hospitalization. Of the 321 still alive after the neonatal hospitalization, 71% were followed until at least 2 years of age; 3,1% died unexpectedly at home. There was a 8% handicap rate (9 with cerebral palsy and 9 with psychomotor deficiency) in the survivors. The problems of the children without handicap consisted mostly of strabismus and psychosocial disturbances. Thus, on admission to the IP on the first day of life during 1978-1980, according to gestational age (a) less than 28 weeks, (b) between 28 and 29 weeks 6 days (c) between 30 and 31 weeks 6 days, a premature presented the following risks: death during hospitalization: (a) 47%, (b) 20% and (c) 15%; death at home (b) 5%, (c) 1%; handicap (a) 3%, (b) 10%, (c) 5%; normal survival (a) 47%, (b) 63%, (c) 75%. This study shows the value of gestational age in estimating the outcome of prematures and the utility of analysing the results according to the 2 variables of gestational age and birth weight.
