Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1993 through December 1994,☆☆,,★★

https://doi.org/10.1016/S0002-9378(98)70037-7Get rights and content
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Abstract

Objectives: Our purpose was to determine the mortality and morbidity rates for infants weighing 501 to 1500 g according to gestational age, birth weight, and gender. Study Design: Perinatal data were collected prospectively on an inborn cohort from January 1993 through December 1994 by 12 participating centers of the National Institute of Child Health and Human Development Neonatal Research Network and were compared with the corresponding data from previous reports. Sociodemographic factors, perinatal events, and the neonatal course to 120 days of life, discharge, or death were evaluated. Results: Eighty-three percent of infants survived until discharge to home or to a long- term care facility (compared with 74% in 1988). Survival to discharge was 49% for infants weighing 501 to 750 g at birth, 85% for those 751 to 1000 g, 93% for those 1001 to 1250 g, and 96% for those 1251 to 1500 g. The majority of deaths occurred within the first 3 days of life. Mortality rates were greater for male than for female infants. Respiratory distress syndrome was the most frequent pulmonary disease (52%). Chronic lung disease (defined as an oxygen requirement at 36 weeks after conception) developed in 19%. Thirty-two percent of infants had evidence of intracranial hemorrhage. Periventricular leukomalacia was noted in 6% of infants who had ultrasonography after 2 weeks. The average duration of hospitalization for survivors was 68 days (122 days for surviving infants weighing 501 to 750 g, compared with an average of 43 days for surviving infants 1251 to 1500 g). Among infants who died, the average length of stay was 19 days. Conclusions: The mortality rate for infants weighing between 501 and 1500 g at birth continues to decline. This increase in survival is not accompanied by an increase in medical morbidity. There are interactions between birth weight, gestational age, sex, and survival rates. (Am J Obstet Gynecol 1998;179:1632-9.)

Keywords

Very low birth weight
morbidity
mortality
National Institute of Child Health and Human Development Neonatal Research Network
prematurity
preterm delivery

Cited by (0)

Supported by a grant from the National Institutes of Health, National Institute of Child Health and Human Development, through Cooperative Agreement with the authors’ institutions: U10 HD27880,a U10 HD27856,c U10 HD27904,d U10 HD21415,e U10 HD27881,f U10 HD21397,g U10 HD27851,h U10 HD21373,i U10 HD21385,j U10 HD21364,k U10 HD27853,l U10 HD27871,m and U01 HD19897.n

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For the National Institute of Child Health, Human Development Neonatal Research Network

Reprint requests: David K. Stevenson, MD, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305-5119.

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