Original Article

Journal of Perinatology (2009) 29, 33–38; doi:10.1038/jp.2008.112; published online 14 August 2008

Maternal and neonatal characteristics of extremely low birth weight infants who die in the first day of life

M M Pont1 and B S Carter1

1Division of Neonatology, Department of Pediatrics, Vanderbilt Children's Hospital, Vanderbilt University Medical Center, Nashville, TN, USA

Correspondence: Dr BS Carter, Division of Neonatology, Department of Pediatrics, Vanderbilt Children's Hospital, Vanderbilt University Medical Center, 11111 Doctor's Office Tower, 2200 Children's Way, Nashville, TN 37232-9544, USA. E-mail: brian.carter@vanderbilt.edu

Received 29 January 2008; Revised 25 June 2008; Accepted 13 July 2008; Published online 14 August 2008.

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Abstract

Objective:

 

To determine changes over time in the characteristics of early extremely low birth weight non-survivors (E-ELBW-NS), maternal characteristics and perinatal management, and the documentation of perinatal consultations.

Study Design:

 

We conducted a chart review of infants <750 g who died within 24 h divided into two epochs: 1 January 1995 to 31 December 1999 and 1 January 2000 to 31 December 2005. Maternal and neonatal characteristics, delivery room resuscitation, post-resuscitation care, and documentation of resuscitation and perinatal counseling were examined.

Result:

 

A total of 138 infants met inclusion criteria. During Epoch 2, there was an increase in black, small for gestational age infants and prior maternal preterm delivery, and decreased incidences of tocolysis and chorioamnionitis. Also, a trend toward more hemolysis elevated liver enzymes and low platelet syndrome and decreased prenatal care existed. Perinatal consultations increased in both number and quality with time.

Conclusion:

 

There has been a shift in racial distribution toward more black infants in the second epoch perhaps reflecting disparities in care. Otherwise, demographics and management of E-ELBW-NS have changed minimally. There has been a significant improvement in the documentation of perinatal consultations.

Keywords:

nonviable, previable, ELBW, mortality, NICU

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