Original Article

Neonatal Outcome of Infants Born at 500 to 800 Grams From 1990 Through 1998 in a Tertiary Care Center

Departments of Pediatrics and Obstetrics and Gynecology, Division of Neonatal/Perinatal Medicine, Schneider Children's Hospital at North Shore, North Shore-Long Island Jewish Health System, Manhasset, NY, USA

Correspondence to: Rita G. Harper, MD, Division of Neonatal/Perinatal Medicine, North Shore-Long Island Jewish Health System, Franklin Hospital Medical Center, 900 Franklin Avenue, Valley Stream, NY 11580, USA

Abstract

OBJECTIVE: To assess if there have been changes in survival, demographic data, obstetric features, neonatal morbidity, and short-term neurologic/radiographic/neurosensory outcome of 500- to 800-g infants born in a tertiary care neonatal center from 1990 through 1998.

STUDY DESIGN: Records of all 500- to 800-g infants born at North Shore University Hospital during 1990-1998 were reviewed to determine demographic data, survival by weight and gestational age (GA), obstetric features, neonatal morbidity, and short-term neurologic/radiographic/neurosensory outcome. Newborn infants were grouped into three triennia: 1990-1992, 1993-1995, and 1996-1998 and compared across time.

RESULTS: Of the 173 infants admitted to the neonatal intensive care unit, 112 survived. Improved survival was documented: 40% in 1990-1992, 73% in 1993-1995, and 81% in 1996-1998 (p<0.0001). Improved survival was also noted in each of the three weight cohorts, as well as in infants £26 weeks GA. An increased use of antenatal corticosteroids and increased number of deliveries by cesarean section (C/S) were noted across time. The incidence of 0 to 3 Apgar scores at both 1and 5 minutes decreased across time. Necrotizing enterocolitis in survivors and expected short-term neurologic/radiographic/neurosensory outcome improved between 1990-1992 and 1996-1998, with a trend toward reduced IVH grade III to IV. The incidence of other neonatal morbidities did not change throughout the time period.

CONCLUSIONS: The data document that survival rates continued to improve for 500- to 800-g infants throughout the 1990s. This was concurrent with an increase in "low-risk, expected normal" infants, increased number of deliveries by C/S, decreased incidence of low Apgar scores at both 1 and 5 minutes, and an increased use of antenatal corticosteroids. Journal of Perinatology (2002) 22, 555-562 doi:10.1038/sj.jp.7210789

October/November 2002, Volume 22, Number 7, Pages 555-562

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