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Characteristics, mortality, and outcome of higher-birth weight infants who require intensive care
Insights
Infants weighing over 2500 grams admitted to intensive care have high mortality rates, despite good outcomes for survivors. This understudied group requires more research to reduce preventable deaths.
Area of Science:
- Neonatal Intensive Care
- Pediatric Mortality Studies
- Infant Health Outcomes
Background:
- Improved outcomes for small infants in intensive care are documented.
- Little emphasis has been placed on the mortality and morbidity of larger infants (>= 2500 gm) requiring intensive care.
Purpose of the Study:
- To highlight the significant mortality and morbidity in infants weighing >= 2500 gm who require intensive care.
- To identify common diagnoses and causes of death in this population.
- To assess the outcomes for survivors and the potential preventability of deaths.
Main Methods:
- Retrospective analysis of infants weighing >= 2500 gm admitted to intensive care over a 2-year period.
- Categorization of diagnoses, causes of mortality, and developmental follow-up of survivors.
Main Results:
- These infants constituted 41% of admissions and 34% of deaths.
- Common diagnoses included pulmonary disease (32%), asphyxia (22%), and congenital anomalies (18%).
- Overall mortality was 11%, with 50% of deaths due to lethal malformations and 26% due to asphyxia; half of deaths were potentially preventable. Over 90% of survivors developed normally.
Conclusions:
- Mortality for infants >= 2500 gm requiring intensive care remains high, despite good outcomes for survivors.
- Lethal malformations and asphyxia are leading causes of death.
- This large, understudied group warrants increased research focus to improve outcomes and reduce preventable mortality.
Abstract:
The improved outcome of small infants who have received intensive care is well documented; however, the mortality and morbidity of infants weighing greater than or equal to 2500 gm who require intensive care have not been emphasized. During a 2-year period these infants accounted for 41% of admissions and 34% of all deaths in our nursery. The most common diagnoses were pulmonary disease (32%), asphyxia (22%), congenital anomalies (18%), infant of diabetic mother (10%), hematologic disease (9%), and infection (4%). Mortality was 11% with 50% of the deaths from lethal malformations, 26% from asphyxia, 13% from infection, and 11% from miscellaneous causes. One half of the deaths were potentially preventable. According to developmental follow-up, over 90% of the survivors were developing normally. Thus, while outcome for survivors is usually good, mortality remains excessively high. This large and understudied group of infants requires increased investigative emphasis.