Document Detail


Trends in neonatal morbidity and mortality for very low birthweight infants.
MedLine Citation:
PMID:  17306659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To document the mortality and morbidity of infants weighing 501-1500 g at birth according to gestational age, birthweight, and sex. STUDY DESIGN: Prospective collection of perinatal events and neonatal course to 120 days of life, discharge, or death from January 1990 through December 2002 for infants born at 16 participating centers of the National Institute of Child Health & Human Development Neonatal Research Network. RESULTS: Compared with 1995-1996, for 1997-2002 the survival of infants with birthweight of 501-1500 g increased by 1 percentage point (from 84% to 85%). Survival without major neonatal morbidity remained static, at 70%; this includes bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), and necrotizing enterocolitis (NEC). Survival increased for multiple births (26%, up from 22%), antenatal corticosteroid use (79%, up from 71%), and maternal antibiotics (70%, up from 62%) (P < .05). From 1997 to 2002, birthweight-specific survival was 55% for infants weighing 501-750 g, 88% for 751-1000 g, 94% for 1001-1250 g, and 96% for 1251-1500 g. More females survived. The incidence of NEC (7%), severe IVH (12%), and late-onset septicemia (22%) remained essentially unchanged, but BPD decreased slightly, from 23% to 22%. The use of postnatal corticosteroids declined from 20% in 1997-2000 to 12% in 2001-2002. Growth failure (weight <10th percentile) at 36 weeks' postmenstrual age decreased from 97% in 1995-1996 to 91% in 1997-2002. CONCLUSION: There have been no significant increases in survival without neonatal and long-term morbidity among VLBW infants between 1997 and 2002. We speculate that to improve survival without morbidity requires determining, disseminating, and applying best practices using therapies currently available, and also identifying new strategies and interventions.
Authors:
Avroy A Fanaroff; Barbara J Stoll; Linda L Wright; Waldemar A Carlo; Richard A Ehrenkranz; Ann R Stark; Charles R Bauer; Edward F Donovan; Sheldon B Korones; Abbot R Laptook; James A Lemons; William Oh; Lu-Ann Papile; Seetha Shankaran; David K Stevenson; Jon E Tyson; W Kenneth Poole;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  196     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-19     Completed Date:  2007-04-12     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  147.e1-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Case Western Reserve University, Cleveland, OH.
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Female
Gestational Age
Humans
Infant Mortality / trends*
Infant, Newborn
Infant, Very Low Birth Weight*
Male
Morbidity / trends
Sex Factors
Survival Analysis
United States / epidemiology
Grant Support
ID/Acronym/Agency:
M01 RR000070/RR/NCRR NIH HHS; M01 RR000750/RR/NCRR NIH HHS; M01 RR000997/RR/NCRR NIH HHS; M01 RR001032/RR/NCRR NIH HHS; M01 RR002172/RR/NCRR NIH HHS; M01 RR002635/RR/NCRR NIH HHS; M01 RR006022/RR/NCRR NIH HHS; M01 RR008084/RR/NCRR NIH HHS; U10 HD021364/HD/NICHD NIH HHS; U10 HD021373/HD/NICHD NIH HHS; U10 HD021385/HD/NICHD NIH HHS; U10 HD021397/HD/NICHD NIH HHS; U10 HD021415/HD/NICHD NIH HHS; U10 HD027851/HD/NICHD NIH HHS; U10 HD027853/HD/NICHD NIH HHS; U10 HD027856/HD/NICHD NIH HHS; U10 HD027871/HD/NICHD NIH HHS; U10 HD027880/HD/NICHD NIH HHS; U10 HD027881/HD/NICHD NIH HHS; U10 HD027904/HD/NICHD NIH HHS; U10 HD034167/HD/NICHD NIH HHS; U10 HD034216/HD/NICHD NIH HHS; U10 HD036790/HD/NICHD NIH HHS; U10 HD040689/HD/NICHD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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