Survival and morbidity of very low birth weight infants in a South American Neonatal Network

Abstract

Objective. To analyze survival and relevant morbidity by gestational age (GA) in very low birth weight (VLBW) infants (<1500 g) and, based on these data, develop a fact sheet to provide information to perinatal healthcare providers and very low birth weight preterm infants´parents. Study Design. Data were prospectively collected in relation to newborn infants with a birth weight between 500 g and 1500 g admitted to 45 sites of the Neocosur Neonatal Network (Red Neonatal Neocosur) between January 2001 and December 2011. Results. Data on 8234 VLBW with a GA between 24 +0 and 31 +6 weeks were analyzed. Overall mortality was 26% (95% CI: 25.0-26.9), including 2.6% of deaths in the delivery room. Fact sheets for survival and morbidity for each week of gestation were developed based on collected data. Survival at discharge increased from 29% at 24 weeks of GA to 91% at 31 weeks of GA (p < 0.001). The incidence of relevant neonatal morbidity was inversely related to GA (p < 0.001). Overall, 30.8% had retinopathy of prematurity, 25% bronchopulmonary dysplasia, 10.9% necrotizing enterocolitis, 7.2% severe intraventricular hemorrhage, and 4.6% periventricular leukomalacia. Among survivors, 47.3% had none of these five conditions. Conclusions. A tool for use in a clinical setting was developed based on updated regional data for establishing week-to-week survival and morbidity of newborn infants born between 24 +0 and 31 +6 weeks of GA. This information could be used to make decisions related to perinatal care and for counseling parents.

Motor and cognitive outcomes of neonates with low birth weight in Brazil: a systematic review and meta-analysis

“…The risk of unfavorable neurodevelopmental outcomes in the first years of life and at school age after intrauterine malnutrition and extreme prematurity has been previously reported by several authors reporting data from developed countries. 4 5 6 38 39 40 41 In the present study, we gathered all data published on the Brazilian population and studied if the low-resource setting might influence neurodevelopmental outcomes.…”

“… 1 The worldwide incidence of deliveries before 37 weeks of gestation is of 11.1%, with large geographical differences, ranging from 5% in developed countries to 18% in countries with less economic power. 4 In South America, the mortality rate of children with VLBW reaches 26%, 4 demonstrating the socioeconomic lability of the countries in that region.…”