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[Clinical study of infants with birth weight less than 1500 grams]
1Department of Pediatrics, Mackay Memorial Hospital, Sin-Lau Christian Hospital, Tainan, Taiwan, R.O.C.
Insights
Mortality rates for infants under 1500 grams were high, especially for those born outside the hospital. Intracranial hemorrhage was the leading cause of death in these extremely premature infants.
Area of Science:
- Neonatal Intensive Care
- Perinatology
- Pediatric Critical Care
Context:
- Study included 177 infants with birth weight < 1500 grams admitted to Mackay Memorial Hospital's NICU in 1987.
- Analysis focused on mortality rates, causes of death, and complications in extremely premature infants.
- Compared outcomes between inborn and outborn infants, noting higher mortality in outborns.
Purpose:
- To analyze mortality rates and identify risk factors in extremely premature infants (<1500g).
- To investigate the primary causes of mortality and common complications.
- To evaluate the impact of birth status (inborn vs. outborn) on survival.
Summary:
- Mortality rates varied significantly by birth weight, with 100% for 500-799g infants and 17-19% for those 1000-1499g.
- Intracranial hemorrhage was the leading cause of death (55%), with most deaths occurring within the first three days.
- Outborn infants had a higher mortality rate than inborn infants (P < .05).
- Respiratory support, including intermittent positive pressure breathing (IPPB) and nasal continuous positive airway pressure (CPAP), was required for most infants.
Impact:
- Highlights the critical need for advanced monitoring and early intervention for intracranial hemorrhage in extremely premature infants.
- Emphasizes the importance of establishing robust transport systems for high-risk neonates.
- Suggests that improved management strategies are essential to reduce mortality and complications associated with extreme prematurity.
Abstract:
One hundred and seventy-seven infants of birth weight less than 1500 grams admitted to the neonatal intensive care unit of Mackay Memorial Hospital in 1987 were studied. The sex distribution, male to female ratio was 100:77, inborn 78 cases, outborn 99 cases. At one year follow-up, the mortality rate of these weighed between 500 gm and 799 gm was 100%, between 800 gm and 999 gm 54%, between 1000 gm and 1249 gm 17%, between 1250 gm and 1499 gm 19% respectively. The mortality rate of outborns was higher than that of inborns (X2 = 6.03, P < .05). The most common cause of mortality of these infants was intracranial hemorrhage, it accounts for 55% of the mortality. Seventy-three percent of the deceased cases expired during the first three hospitalization days. Of these 177 cases, 94 were put on respirator with IPPB initially, another 47 cases were on nasal CPAP. Only 36 cases didn't require respiratory therapy. Complications of the extreme prematurity and management including intraventricular hemorrhage, pulmonary hemorrhage, sepsis, pneumothorax, persistent pulmonary hypertension, disseminated intravascular coagulopathy, electrolyte imbalance, bronchopulmonary dysplasia and retinopathy of prematurity were discussed. In order to improve survival and reduce complications of these extreme prematurity, advanced monitoring system, early detection and prevention of intracranial hemorrhage, establishment of the transport system are essential.