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Improving survival of the very premature infant
1Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill 27599-7570.
Insights
Survival rates for premature infants born before 28 weeks
Area of Science:
- Neonatalogy
- Perinatology
- Pediatric Medicine
Background:
- Current data on survival and morbidity for premature infants is essential for perinatal decision making.
- Accurate counseling of families requires up-to-date information on outcomes for preterm infants.
Purpose of the Study:
- To review survival and severe morbidity for liveborn infants of less than 28 weeks' gestation.
- To compare outcomes for infants born before 26 weeks' gestation between two study periods.
Main Methods:
- Review of survival and severe morbidity data for a cohort of 93 infants.
- Analysis of data from July 1989 to August 1991.
- Comparison with historical data from 1986 through 1988 for infants < 26 weeks' gestation.
Main Results:
- Survival to hospital discharge was 73% for infants born before 28 weeks' gestation.
- Twenty-eight percent of survivors experienced severe morbidity (grade 3-4 intraventricular hemorrhage or oxygen requirement at discharge).
- Significant improvement in survival without increased morbidity was observed for infants < 26 weeks' gestation compared to previous years.
Conclusions:
- There has been a generalized improvement in the outcome of infants of very low birth weight.
- Survival and morbidity rates were similar between racial groups and sexes.
Abstract:
Knowledge of current data on survival and morbidity for premature infants is essential for perinatal decision making and accurate counseling of families. Survival and severe morbidity were reviewed for liveborn infants of less than 28 weeks' gestation. Between July 1989 and August 1991, in a cohort of 93 infants with a mean birth weight of 887 gm, survival until hospital discharge to home was 73%. Twenty-eight percent of survivors had either grade 3 or 4 intraventricular hemorrhage or an oxygen requirement at hospital discharge. In the subset of infants of less than 26 weeks' gestation, survival has significantly improved without a rise in morbidity when the data from the study period were compared with data from 1986 through 1988. Survival and morbidity were similar between black and white infants and between girls and boys. These data, along with reports from other tertiary centers, indicate a generalized improvement in the outcome of infants of very low birth weight.