Abstract
Studies on VLBW infants often include outborn and SGA infants and do not describe the effects of short gestation on mortality and morbidity. This study documents the outcome of 138 infants born in a perinatal center (1977-1980) of whom 64 were born at 24-26 weeks gestation (Group I) and 74 were born at 27-28 weeks gestation (Group II). 81 were discharged alive. Neurological status was determined in all 80 longterm survivors and 72 (90%) had psychometric testing at 24 months corrected age. Major handicap included cerebral palsy, blindness, deafness, and Bayley MDI <69 and minor handicap included tone disorder, refractive error, conductive deafness and attention deficit. For Group I infants mean birthweight (gms) was lower (807 v 1049, p<0.0001), hospital survival was reduced (45% v 70%, p<0.005) and rates for major (31% v 8%) and minor handicap (28% v 12%) were increased (p<0.001). Mean Bayley scores were similar (MDI 91 v 92, PDI 82 v 88). Analysis of perinatal variables showed that Group I babies were more critically ill and unstable with significantly lower 5 minute Apgar score, admission temperature, arterial pH and haematocrit; higher FiO2 requirements and arterial PCO2 levels. Duration of ventilation and oxygen therapy and incidence of stage 3/4 BPD (45% v 4%) and all grades of RLF (16% v 3%) were significantly increased. This study shows that shortened gestation is associated with increased mortality and morbidity and may be more specific than birth weight in predicting outcome.
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Orgill, A., Astbury, J., Bajuk, B. et al. OUTCOME OF INFANTS LESS THAN 29 WEEKS GESTATION. Pediatr Res 18 (Suppl 4), 338 (1984). https://doi.org/10.1203/00006450-198404001-01469
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DOI: https://doi.org/10.1203/00006450-198404001-01469