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

AUTHORS

Guang Yue 1 , Ying Dong 2 , Jia-lin Yu 2 , *

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

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

How to Cite: Yue G, Dong Y, Yu J. Changes in Perinatal Care and Predictors of In-Hospital Mortality for Very Low Birth Weight Preterm Infants , Iran J Pediatr. 2015 ; 22(3):326-332.

ARTICLE INFORMATION

Iranian Journal of Pediatrics: 22 (3); 326-332
Published Online: September 30, 2012
Article Type: Research Article
Received: April 20, 2011
Accepted: March 03, 2012

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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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