Considerable mortality and morbidity in neonates born below 500 gram

Abstract

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Morbidity and mortality in extremely premature infants with a birth weight ≤500 g

“…In the future, it will be important to delineate underlying pathophysiological mechanisms (eg inflammation) that contribute to this pattern. Moreover, we agree with Goeral et al and Upadjyay et al 1,3 that the delivery of neonates at the threshold of viability comes with a plethora of difficult and complex ethical issues. In the grey zone of viability, evidence-based data are necessary to guide prenatal counselling and allow for informed shared decision-making.…”

“…103 (56.3%) were non-SGA (mean gestational age 25 + 1 weeks ±9.9 days and mean birth weight 662.6 ± 75.2 g) and 80 (43.7%) SGA (mean gestational age 26 + 6 weeks ±14.0 days and mean birth weight 543.9 ± 114.7 g). Of these SGA infants, 34/80 had a birth weight <3rd percentile, which is substantially lower than the rate reported by Goeral et al 1 Mortality was 24.1% (non-SGA: 30/103 (29.1%) and SGA: 14/80 (17.5%); p = 0.08). In our study, univariable logistic regression analysis revealed a significant protective effect of SGA status on pneumothoraces (OR 0.28, 95%-CI [0.11-0.69]), IVH (≥3) (OR 0.38; 95%-CI [0.15-0.67]) and seizures (OR 0.09, 95%-CI [0.01-0.76]), but NEC (≥2a) occurred more frequently in SGA neonates (p = 0.024).…”

“…To avoid data interpretation bias, analysis of all live births regardless of proactive or palliative care as well as those dying in the delivery room after insufficient stabilisation is mandatory. 1 Moreover, generating local data on mortality and major morbidities including information on SGA status may prove valuable in antenatal counselling in this highly susceptible cohort, since these data may differ significantly from other reports. 2,4…”

“…In their retrospective analysis including 59 preterm infants with a birth weight ranging from 318 to 500 g (56% of neonates ≤3rd percentile) and gestational age from 23 to 29 weeks, Goeral et al demonstrated that 88% received standard care; and survival rate was 37% for all live births and 42% for infants with standard care. 1 Neurodevelopmental outcome assessment was available in 91% of patients (Bayley Scales of Infant Development at two years) with 50% demonstrating a favourable mental development (normal or mild impairment), 75% a favourable motor development and 45% a favourable outcome in both outcome subcategories. When additionally considering visual and hearing disability and/or cerebral palsy level ≥2 according to the Gross Motor Function Classification System (GMFCS), 35% had a good neurodevelopmental outcome.…”

Outcomes at 18–24 Months of Infants with Birth Weight under 500 g Born in Korea during 2013–2017: A Nationwide Cohort Study

“…To date, only a small number of reports on the outcomes beyond the neonatal period of infants with a BW <500 g have been published. Recent studies revealed unfavorable outcomes: >50% of such infants reportedly have neurodevelopmental impairments (NDIs) at ages two and 3 years [6, 7]. The neurodevelopmental outcome beyond the neonatal period of Korean infants with a BW <500 g has not yet been reported.…”