| Nursery survival for infants of birth weight 500-1500 grams during 1982-1995. | |
| | |
MedLine Citation:
|
PMID: 11324368 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To evaluate nursery survival of very low birth weight infants (VLBW) over time, born in the same large inner-city hospital with a predominantly Hispanic population. METHODS: All liveborn VLBW infants weighing 500-1500 g at birth were included in four time periods of 2 years' duration during 1982 to 1995. Demographics were collected for the obstetric population. Clinical data were collected including maternal and infant perinatal factors. All infants were assigned a cause of death and infants dying with lethal anomalies were then excluded from further evaluations. RESULTS: Overall survival improved progressively (p = 0.0001) with dramatic improvement in survival of infants 500-750 g birth weight (BW) in period 4 (1994-1995). The number of lethal anomalies did not increase but accounted for a larger portion of deaths in period 4. Decreases in other causes of death over time reflected changes in perinatal care. Although the mothers were high-risk, none of the maternal factors evaluated showed any consistent effect on infant survival. Improved labor and delivery care was associated with improvement in Apgar scores, a decrease in intracranial hemorrhage/intraventricular hemorrhage as a cause of death and an improvement in survival between the first two periods. In spite of the increase in Cesarean sections for infants of 500-750 g BW and their improved survival in period 4, no clear advantage for Cesarean section could be demonstrated. The marked improvement seen in period 4 was associated with three changes in care: increased use of maternal steroids, administration of surfactant, and the use of newer ventilatory methods including high-frequency oscillatory ventilation. Although female gender has been reported to confer a protective influence for survival, this was not found in the final period. Black mothers comprised only about 2.5% of the total obstetric population but delivered approximately 10% of the VLBW infants. Despite the increased incidence of small for gestational age (SGA) among black infants, there were no differences in survival between blacks and Hispanics. Mean birth weight and gestational age in both survivors and nonsurvivors decreased significantly over the four time periods. In period 4, 50% survival occurred at a birth weight of 600-700 g and a gestational age of 23 weeks. CONCLUSION: Nursery survival improved throughout the period of the study from 1982 to 1995 but especially during period 4 (1994-1995). Improved survival was associated with changes in both maternal and infant care. In infants of BW 500-750 g, gestational age rather than birth weight was more closely associated with survival. |
| | |
Authors:
|
A J Teberg; J E Hodgman; L Barton; L S Chan |
Related Documents
:
|
18437028 - Perinatal risk factors and mode of delivery correlated to survival and psychomotor disa... 8549738 - A birth weight for gestational age standard based on data in the swedish medical birth ... 17311798 - Genetic and environmental influences on birth weight, birth length, head circumference,... 1986448 - Effect of stress on birth weight in two johannesburg populations. 4030638 - Assessment of protein quality methodology for infant formulas. 12808268 - Autonomic imbalance as a property of symptomatic brugada syndrome. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of perinatology : official journal of the California Perinatal Association Volume: 21 ISSN: 0743-8346 ISO Abbreviation: J Perinatol Publication Date: 2001 Mar |
Date Detail:
|
Created Date: 2001-04-27 Completed Date: 2001-09-06 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 8501884 Medline TA: J Perinatol Country: United States |
Other Details:
|
Languages: eng Pagination: 97-106 Citation Subset: IM |
Affiliation:
|
Departments of Pediatrics and Biostatistics, Division of Newborn Medicine, Keck School of Medicine of the University of Southern California, CA, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
African Americans Delivery, Obstetric / statistics & numerical data Female Hispanic Americans* Humans Infant Mortality* Infant, Newborn Infant, Very Low Birth Weight* Male Maternal Age Pregnancy Pregnancy Complications / ethnology Survival Analysis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Physicians who induce labor for fetal macrosomia do not reduce cesarean delivery rates.
Next Document: Cardiovascular risk factors: distribution and prevalence in a rural population of Bangladesh.