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[Three year outcome for infants of birth weight less than 1800 g]
1Shijonawate Public Health Center, Osaka Prefectural Government.
Insights
Modern care for very low birthweight infants shows improved outcomes. Specialized neonatal intensive care units (NICUs) significantly increase survival without handicap for infants between 1000-1500g.
Area of Science:
- Neonatal care
- Pediatric outcomes
- Public health
Context:
- The effectiveness of modern neonatal intensive care for very low birthweight infants is debated, with concerns about potential increases in childhood handicaps.
- A study in Osaka Prefecture tracked 359 infants born in 1985 (birth weight < 1800g) for 3 years, comparing outcomes to a 1980 cohort.
Purpose:
- To analyze the outcomes (survival without handicap, survival with handicap, mortality) of very low birthweight infants based on their care setting.
- To compare these outcomes with a historical cohort to identify trends in care effectiveness.
Summary:
- In 1985, 66.9% of infants survived without handicap, 14.2% with handicap, and 18.9% died.
- Infants in the 1000-1500g birthweight range receiving care at children's hospitals with Neonatal Intensive Care Units (NICUs) had significantly better outcomes (75% without handicap) compared to other hospitals (54%).
- Mortality rates for infants in the 1000-1500g range were significantly lower at NICU-equipped children's hospitals (10%) versus other facilities (26%).
- Comparing 1985 to 1980, there was a slight increase in both handicap-free survival (67% vs 61%) and handicap rates (14% vs 11%), but a notable decrease in mortality (19% vs 28%).
Impact:
- Neonatal intensive care units (NICUs) play a crucial role in improving survival rates and reducing handicaps among very low birthweight infants.
- The findings suggest that specialized care settings positively influence long-term outcomes for vulnerable newborns.
- Continued monitoring and comparison with historical data are essential for evaluating and advancing neonatal care practices.
Abstract:
The effectiveness of modern methods of care for very low birthweight infants has been questioned from the standpoint of the possibility that the application of these methods may result in an increase in handicapped children. During 1985, 435 infants of birth weight less than 1800 g were born in Osaka prefecture and 359 of these infants were followed for 3 years to analyze outcome. Proportion of children without handicap, with handicap, and children who died were determined. These results were compared with another study which showed outcome for infants born in 1980 in Osaka. 1. Of the 359 children, 66.9% were alive without handicap, and 14.2% with handicap, and 68 (18.9%) children died, 10 of whom died from congenital disorder. 2. There were significant differences in the proportion of children without handicap in the BW range 1000 g-1500 g between infants cared at children's hospitals which have NICU. and other hospitals. (75% vs 54% P < 0.05) 3. While the proportion of children with handicap was greater for all BW ranges in infants care at children's hospitals which have NICU. than other hospitals, the difference was not significant. 4. There were significant differences in the proportion of children who died in the BW range 1000 g-1500 g between infants cared at children's hospitals which have NICU. and other hospitals. (10% vs 26% P < 0.05) 5. There was an increase in the proportion of children without handicap (67% vs 61%), and with handicap (14% vs 11%), but a decrease in children who died (19% vs 28%) between low birthweight infants born in 1985 and in 1980.