Factors affecting survival in infants weighing 750g or less

Locatelli, Anna; Roncaglia, Nadia; Andreotti, Camilla; D’Oria, Valentina; Doni, Daniela; Pezzullo, John C.; Ghidini, Alessandro

doi:10.1016/j.ejogrb.2005.03.003

Cited by 12 publications

(5 citation statements)

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“…The studies included 28 which predicted outcome for a general VLGA/BW population [7]–[34] and 13 studies specific to ELGA/BW infants [35]–[47]. Of these 13 studies, 7 focused on the youngest and smallest of the ELGA/BW infants [36], [38], [39], [41], [44]–[46].…”

Section: Resultsmentioning

confidence: 99%

“…The included studies represent populations from 21 countries, and seven of the included prediction models are specifically for use in low-resource or mixed-resource settings [16], [25], [27], [30]–[32], [34]. The number of VLGA/BW infants included in each of the studies ranged from 59 [41] to 12960 [15], and the mortality rate among these infants ranged from 6.8% [28] to 59.6% [37]. Infants were included in the study population at the onset of labor/decision to deliver in 3 studies, at live birth in 12 studies, on NICU admission or the start of mechanical ventilation in 13 studies, after survival of 1–24 hours in 5 studies, or survival for >1 day in 4 studies.…”

Section: Resultsmentioning

confidence: 99%

“…Prediction models which are created with a smaller range of gestational ages and birth weights are likely to be more useful for clinical decisions in this group of infants, as the model will depend less on weight and age. No study in this review explicitly stated that the model was developed to assist with clinical decision making in the group of infants where clinicians feel uncertain in their clinical judgment, although the seven studies predicting mortality in the youngest and smallest ELGA/BW infants [36], [38], [39], [41], [44]–[46] may have been implicitly directed toward this goal. Clinical predictions based on the appearance of the infant at birth are often inaccurate [50], [51], and it is known that clinicians who over-predict death also tend to perform less resuscitation and other therapies, leading to the potential for a self-fulfilling prophecy [42].…”

Section: Discussionmentioning

confidence: 99%

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Prediction of Mortality in Very Premature Infants: A Systematic Review of Prediction Models

et al. 2011

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ContextBeing born very preterm is associated with elevated risk for neonatal mortality. The aim of this review is to give an overview of prediction models for mortality in very premature infants, assess their quality, identify important predictor variables, and provide recommendations for development of future models.MethodsStudies were included which reported the predictive performance of a model for mortality in a very preterm or very low birth weight population, and classified as development, validation, or impact studies. For each development study, we recorded the population, variables, aim, predictive performance of the model, and the number of times each model had been validated. Reporting quality criteria and minimum methodological criteria were established and assessed for development studies.ResultsWe identified 41 development studies and 18 validation studies. In addition to gestational age and birth weight, eight variables frequently predicted survival: being of average size for gestational age, female gender, non-white ethnicity, absence of serious congenital malformations, use of antenatal steroids, higher 5-minute Apgar score, normal temperature on admission, and better respiratory status. Twelve studies met our methodological criteria, three of which have been externally validated. Low reporting scores were seen in reporting of performance measures, internal and external validation, and handling of missing data.ConclusionsMultivariate models can predict mortality better than birth weight or gestational age alone in very preterm infants. There are validated prediction models for classification and case-mix adjustment. Additional research is needed in validation and impact studies of existing models, and in prediction of mortality in the clinically important subgroup of infants where age and weight alone give only an equivocal prognosis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prediction of Mortality in Very Premature Infants: A Systematic Review of Prediction Models

et al. 2011

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“…A Low 5-min Apgar score has previously been reported as a predictor of neonatal mortality. Locatelli et al [18] showed that small for gestational age and birth weight, female gender, low 5-min Apgar score and failure of steroid administration were independent predictors of survival in infants weighing 750 g or less. Cumulatively, these five predictors explained 69% of neonatal survival.…”

Section: Discussionmentioning

confidence: 99%

Effect of pregestational maternal, obstetric and perinatal factors on neonatal outcome in extreme prematurity

Wang

Tanbo

Ellingsen

et al. 2011

Arch Gynecol Obstet

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PurposeTo investigate the effect of pregestational maternal, obstetric and perinatal factors on neonatal outcome in extreme preterm deliveries.MethodsRetrospective study of deliveries in a Norwegian tertiary teaching hospital. All women with live births at 24+0– 27+6 weeks of gestation between 2004 and 2007 were included. Major morbidity is defined as intraventricular haemorrhage grade 3–4, periventricular leukomalacia, bronchopulmonary dysplasia or necrotizing enterocolitis. Pregestational maternal, obstetric and perinatal variables were initially compared for mortality and survival with major morbidity at 24-h, 7- or 28-day postpartum/discharge in univariate analysis. Then, a multivariate analysis was conducted in order to determine independent factors associated with mortality and survival with major morbidity.ResultsA total of 109 babies were delivered alive in 92 women, representing 1.6% of total births. The survival rates were 93.6, 84.4 and 80.7%, with a prevalence of major morbidity among survivors of 40.4, 32.1 and 39.4% at 24-h, 7- and 30-day postpartum/discharge, respectively. After adjustment using multiple logistic regression, only a 5-min Apgar score ≤3 and babies with at least one major morbidity had significantly independent effects on neonatal survival. Multiple pregnancy and gestational age <26 weeks were the only two independent risk factors for survival with major morbidity.ConclusionsNeonatal survival was significantly predicted by a 5-min Apgar score and neonatal morbidity, independent of pregestational maternal disease, obstetric complications, method of delivery, gestational age and birth weight in extreme preterm deliveries. The excess morbidity rate was confined among multiples and babies who were delivered before 26 weeks of gestation.

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“…Our study showed that the risk factors most closely associated with neonatal mortality in Neonate Intensive Care Unit were respiratory distress (42%), prematurity (19%), low birth weight (11%), multiple births more than 3 (66%) and vaginal delivery (68%). Locatelli et al (2005) showed that smaller gestational age and birth weight, female gender, low fiveminute Apgar score and failure of steroid administration were independent predictors of survival (22) . Chen et al (2005) found that, with multiple logistic regression analysis, only low birth weight and intraventricular hemorrhage grades were the significant predictors of unfavorable outcomes (23) .…”

Section: Discussionmentioning

confidence: 99%

Assessment of Factors Causing Mortality Rate of Neonate in Al-Batool Teaching Hospital in Mosul City

Mahmood

Sulaiman

2013

Kufa Jour. Nurs. Sci.

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Objective: The study aim to find out the neonatal mortality rate among the neonates admitted for a period year to the neonatal intensive care unit in Al-Batool Teaching Hospital in Mosul city. Methodology: A retrospective study the sample collecting of review the register for neonate intensive care unit in AL-Batool Teaching Hospital through one year 2010 (January-December). It registry (341) deaths of neonate. Were (180) male, and (161) female with duration of stay in Neonate Intensive Care Unit between (1-3) days old. Data collected for period of (1/12/2011) to (25/1/2012). Results: of the (23198) infant admitted to intensive care unit at Al-Batool Teaching Hospital in Mosul City within one year 2010 (January to December), 341 died. The 4 common causative illnesses were respiratory distress syndrome (42 %), prematurity (19%) and congenital abnormality (14%) and low birth weight (11%). Ninety three percent of deaths of neonate occurred within the first three days of their life. The mortality rate increased with the low in birth weight, as well as gestational age between (29-30Wks). For early-neonatal mortality, odds were observed for birth weight less than 2,500 g or gestation less than 35 weeks. Conclusion: This study concluded that over a quarter of mother age were (31-35) years old (twenty seven percent), while, the thirty eight percent of neonate were died within three days after born. The predominance of males for death (Fifty three percent) and (twenty nine percent) of them birth weight was (500 - 999 g). Sixty eight percent were delivered of normal vaginal delivery, with very high case fatality rate (Twenty five) those who were delivered (29th - 30th) weeks. Respiratory distress was the commonest primary diagnosis (Forty two percent) among all admitted neonates, followed by premature (Nineteen percent), congenital malformations (Fourteen percent), and low birth weight (Eleven percent). Recommendation: This study recommended that a need for great efforts to determine and reduce risk factors associated with neonatal mortality, and to adequately evaluate the medical and nursing care provided in neonate intensive care units. A neonatal care for pregnant woman is the key for safe neonatal life.

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Factors affecting survival in infants weighing 750g or less

Cited by 12 publications

References 10 publications

Prediction of Mortality in Very Premature Infants: A Systematic Review of Prediction Models

Prediction of Mortality in Very Premature Infants: A Systematic Review of Prediction Models

Effect of pregestational maternal, obstetric and perinatal factors on neonatal outcome in extreme prematurity

Assessment of Factors Causing Mortality Rate of Neonate in Al-Batool Teaching Hospital in Mosul City

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