Changes in Perinatal Care and Predictors of In-Hospital Mortality for Very Low Birth Weight Preterm Infants

Guang Yue; Ying Dong; Jia-lin Yu

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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Changes in Perinatal Care and Predictors of In-Hospital Mortality for Very Low Birth Weight Preterm Infants

Author(s):

Guang Yue¹,

Ying Dong²,

Jia-lin Yu^2,*

1Department of Neonatology, Women and children’s Hospital, Chengdu, China

2Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China

IJ Pediatrics:Vol. 22, issue 3; 326-332

Published online:Sep 30, 2012

Article type:Research Article

Received:Apr 20, 2011

Accepted:Mar 03, 2012

How to Cite:Guang YueYing DongJia-lin YuChanges in Perinatal Care and Predictors of In-Hospital Mortality for Very Low Birth Weight Preterm Infants.Iran J Pediatr.22(3):326-332.

Abstract

Objective: Mortality of very low birth weight premature infants is of great public health concern. To better guide local intervention program, it is essential that current and reliable statistics be collected to understand the factors associated with mortality of these infants.
Methods: Data of very low birth weight premature infants admitted to a neonatal unit during 2002-2009 was retrospectively collected. Changes in perinatal care between two halves of the study period (2002-2005 and 2006-2009) were identified. Factors associated with in-hospital mortality were found by logistic regression and a predictive score model was established.
Findings: A total of 475 cases were enrolled. In-hospital mortality decreased from 29.8% in 2002-2005 to 28.1% in 2006-2009 (P>0.05). More infants born<28 gestational weeks survived to discharge in the latter epoch (38.1% vs 8.3%, P<0.05). Persistent pulmonary hypertension of newborn, pulmonary hemorrhage, birth weight <000 grams, gestational age <33 weeks, feeding before 3 postnatal days and enteral feeding were found predictors of in-hospital mortality by logistic regression. The discriminating ability of the predictive model was 82.4% and the cutoff point was -0.56.
Conclusion: Survival of very low birth weight premature neonates was not significantly improved in 2006-2009 than 2002-2005. Infants with a score higher than -0.56 were assessed to be at high risk of in-hospital mortality. Multi-center studies of planned follow-up are needed to develop a comprehensive and applicable score system.

Keywords

Premature Infant

Very Low Birth Weight

Mortality

Predictive Score Model

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