The spectrum of clinical problems and outcome in infants in a neonatal unit

We report on a retrospective analysis of admissions to the neonatal unit at the Johannesburg Hospital during the 18-month period September 1980 - February 1982. There were 451 admissions during this period, and 47% of the total group required assisted ventilation; 38% were referred from other hospitals (outborn), of whom 74% required ventilation. Hyaline membrane disease (HMD) accounted for 30% of all major diagnoses and was the most common single diagnosis made in infants weighing less than 2 500 g at birth. HMD also occurred in 20 infants weighing more than 2 500 g at birth, in many cases being the result of elective delivery. The neonatal survival rate (first 28 days) according to birth weight was as follows: 751-1 000 g - 76%; 1 001-1 500 g - 83%; 1 501-2 000 g - 93%; and greater than 2 000 g - 89%. Mortality was higher among ventilated outborn infants than among ventilated inborn infants in all weight groups, but the differences were not statistically significant. Long-term follow-up of these infants is in progress.