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Mortality and Morbidity in Extremely Low Birth Weight (ELBW) Infants in a Neonatal Intensive Care Unit

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Abstract

Objective

To determine the morbidity and mortality in ELBW babies till discharge from a Neonatal Intensive Care Unit (NICU).

Methods

This study was a prospective observational study conducted in a 40 bed well equipped level III care NICU between 01.12.2006 and 30.04.2008. All ELBW babies admitted during this period were assessed for morbidities and interventions required during NICU stay and for their outcome like survival or death.

Results

The survival rate of 87 ELBW babies admitted during this period was 56.1 %. Pulmonary hemorrhage was the commonest cause of death (25 %) followed by respiratory distress syndrome (22.5 %), intraventricular hemorrhage (22.5 %) and sepsis (20 %). Significantly higher number of non-survivors were <750 g at birth (p = 0.0001) and <28 wk gestation (p = 0.0001). Small for gestational babies had better chances of survival compared to those appropriate for gestational age (p = 0.005). RDS (67.8 %), probable sepsis (62.1 %) and hyperbilirubinemia (59.8 %) were the most frequent morbidities. Conventional ventilation (72.4 %) and nasal CPAP(48.3 %) were the commonest respiratory interventions. Surfactant replacement therapy was required in 47.1 % babies.

Conclusions

ELBW babies have a major contribution to mortality in a NICU. Babies with birth weight <750 g and gestation <28 wk have poor survival. RDS, pulmonary hemorrhage, IVH and sepsis are the common causes of death while RDS, sepsis and hyperbilirubinemia are the most common morbidities.

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References

  1. Hack M, Friedman H, Fanaroff A. Outcomes of extremely low birth weight infants. Pediatrics. 1996;98:931–7.

    PubMed  CAS  Google Scholar 

  2. Hoffman EL, Bennett FC. Birth weight less than 800 grams: changing outcomes and influences of gender and gestation number. Pediatrics. 1990;86:27–34.

    PubMed  CAS  Google Scholar 

  3. Hack M, Fanaroff AA. How small is too small? Considerations in evaluating the outcome of the tiny infant. ClinPerinatol. 1988;15:773–88.

    CAS  Google Scholar 

  4. Ferrara TB, Hoekstra RE, Gaziano E, Knox GE, Couser RJ, Fangman JJ. Changing outcome of extremely premature infants (<26 weeks’ gestation and <750 gm): survival and follow-up at a tertiary center. Am J Obstet Gynecol. 1989;161:1114–8.

    PubMed  CAS  Google Scholar 

  5. Narang A, Kumar P, Kumar R, Dutta S. Out-come of extremely low birth weight (ELBW) babies. Paper presented at the XXth Annual Convention of the National Neonatology Forum of India, Mumbai, 3rd–5th Nov, 2000.

  6. Narayan S, Aggarwal R, Upadhyay A, Deorari AK, Singh M, Paul VK. Survival and morbidity in extremely low birth weight (ELBW) infants. Indian Pediatr. 2003;40:130–5.

    PubMed  Google Scholar 

  7. Roy KK, Baruah J, Kumar S, Malhotra N, Deorari AK, Sharma JB. Maternal antenatal profile and immediate neonatal outcome in VLBW and ELBW babies. Indian J Pediatr. 2006;73:669–73.

    Article  PubMed  CAS  Google Scholar 

  8. Sehgal A, Telang S, Passah SM, Jyothi MC. Maternal and neonatal profile and immediate outcome in ELBW babies. Indian Pediatr. 2003;40:991–5.

    PubMed  Google Scholar 

  9. Ballard JL, Khoury JC, Wedig K, Want L, Eilers-Walsman BL, Lipp R. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991;l19:417–23.

    Google Scholar 

  10. National Neonatal–Perinatal Database Report. NNPD Network. Indian Council of Medical Research 2002–2003.

  11. Silverman WA, Anderson DH. A controlled clinical trial of effects of water mist on obstructive respiratory signs, death rate, and necropsy findings among premature infants. Pediatrics. 1956;17:1–10.

    PubMed  CAS  Google Scholar 

  12. Walsh MC, Kliegman RM. Necrotisingenterocolitis: treatment based on staging criteria. Pediatr Clin North Am. 1986;33:179.

    PubMed  CAS  Google Scholar 

  13. Maisels MJ, Watchko JF. Treatment of jaundice in low birth weight infants. Arch Dis Child Fetal Neonatal Ed. 2003;88:F459–63.

    Article  PubMed  CAS  Google Scholar 

  14. Papile LA. Incidence and evolution of subependymal intraventricular hemorrhage: a study of infants less than 1500 grams. J Pediatr. 1978;92:529.

    Article  PubMed  CAS  Google Scholar 

  15. Hack M, Taylor HG, Klein N, Mercuri-Minich N. Functional limitations and special health needs of 10 to 14-year-old children weighing less than 750 grams at birth. Pediatrics. 2000;106:554–60.

    Article  PubMed  CAS  Google Scholar 

  16. LaPine TR, Jackson JC, Bennet FC. Outcome of infants weighing less than 800 grams at birth: 15 years’ experience. Pediatrics. 1995;96:479–83.

    CAS  Google Scholar 

  17. Grogaard JB, Lindstrom DP, Parker RA, Culley B, Stahlman MT. Increased survival rate in very low birth weight infants (1500 grams or less): No association with increased incidence of handicaps. J Pediatr. 1990;117:139–46.

    Article  PubMed  CAS  Google Scholar 

  18. Markestad T, Kaaresen P, Ronnestad A, et al; Norwegian Extreme Prematurity Study Group. Early death, morbidity and need of treatment among extremely premature infants. Pediatrics. 2005;115:1289–98.

    Article  PubMed  Google Scholar 

  19. Wilson-Costello D, Friedman H, Minich N, Fanaroff A, Hack M. Improved survival rates with increased neurodevelopmental disability for extremely low birth weight infants in the 1990s. Pediatrics. 2005;115:997–1003.

    Article  PubMed  Google Scholar 

  20. Wood N, Marlow N, Costeleo D, Chir B, Gibson A, Wilkinson A, et al. Neurologic and developmental disability after extremely preterm birth. N Eng J Med. 2000;343:378–84.

    Article  CAS  Google Scholar 

  21. Tommiska V, Heinonen K, Ikonen S, et al. A national short term follow up study of extremely low birth weight infants born in Finland in 1996–1997. Pediatrics. 2001;107:e2–e10.

    Article  PubMed  CAS  Google Scholar 

  22. Modanlou HD, Dorchester WL, Thorosian A, Freeman RK. Antenatal versus neonatal transport to a regional perinatal center: a comparison between matched pairs. Obstet Gynecol. 1979;53:725–9.

    PubMed  CAS  Google Scholar 

  23. Kollee LAA, Verloove-Vanhorick PP, Verwey RA, Brand R, Ruys JH. Maternal and neonatal transport: results of a national collaborative survey of preterm and very low birth weight infants in the Netherlands. Obstet Gynecol. 1988;72:729–32.

    PubMed  CAS  Google Scholar 

  24. Arad I, Gofin R, Baras M, Bar-Oz B, Peleg O, Epstein L. Neonatal outcome of inborn and transported very-low-birth-weight infants: relevance of perinatal factors. Eur J Obstet GynecolReprod Biol. 1999;83:151–7.

    Article  CAS  Google Scholar 

  25. Valcamonico A, Accorsi P, Sanzeni C, et al. Mid- and long-term outcome of extremely low birth weight (ELBW) infants: an analysis of prognostic factors. J Matern Fetal Neonatal Med. 2007;20:465–71.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Sudha Chaudhari.

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Tagare, A., Chaudhari, S., Kadam, S. et al. Mortality and Morbidity in Extremely Low Birth Weight (ELBW) Infants in a Neonatal Intensive Care Unit. Indian J Pediatr 80, 16–20 (2013). https://doi.org/10.1007/s12098-012-0818-5

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  • DOI: https://doi.org/10.1007/s12098-012-0818-5

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