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Infants of very low birthweight. A 15-year analysis
Insights
Survival rates for very-low-birth-weight infants showed no significant improvement over 15 years. Despite advances in care, neonatal mortality and handicap rates remained largely unchanged for these vulnerable newborns.
Area of Science:
- Neonatalogy
- Perinatology
- Pediatric Outcomes Research
Background:
- Very-low-birth-weight (VLBW) infants (501–1500 g) represent a high-risk population.
- Long-term outcomes for VLBW infants born between 1961 and 1975 require continued investigation.
Purpose of the Study:
- To evaluate trends in neonatal mortality and long-term handicap rates among VLBW infants.
- To assess the impact of evolving medical care on survival and neurodevelopmental outcomes in this cohort.
Main Methods:
- Retrospective analysis of 357 liveborn VLBW infants at Hammersmith Hospital (1961–1975).
- Categorization of outcomes including neonatal mortality, late mortality, handicap (major/minor), and normal development.
- Comparison of outcomes across three 5-year periods to identify trends.
Main Results:
- Overall neonatal mortality was 58.5%; late mortality (4–25 months) was 1.4%.
- No significant improvement in neonatal mortality was observed across the three 5-year periods.
- Survival of small-for-gestational-age (SGA) VLBW infants improved in the last period compared to the first; SGA infants had better survival than appropriate-for-gestational-age infants.
- The proportion of handicapped children among VLBW survivors remained unchanged (5.3% major, 5.6% minor).
Conclusions:
- Despite advances in neonatal care, significant improvements in survival and reduction in handicaps for VLBW infants were not evident during 1961–1975.
- Small-for-gestational-age VLBW infants demonstrated improved survival trends in later years.
- Further research is needed to understand and improve long-term outcomes for VLBW populations.
Abstract:
357 babies weighing 501--1500 g were born alive at Hammersmith Hospital in 1961--75. 58.5% died in the neonatal period and 1.4% at 4--25 months of age. 1.4% of the total are untraced, 5.3% have major handicap, 5.6% have minor handicap, and 27.8% are apparently normal. There was no significant improvement in neonatal mortality in three 5-year periods, 1961--65, 1966--70, and 1971--75, except that more small-for-gestational-age babies survived in the last period than in the first. More of these babies survived than did babies whose birthweight was appropriate for gestational age. There was no significant improvement in the proportion of handicapped children among the very-low-weight liveborn babies throughout the 15-year period, despite increasing complexity of care.