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DIFFERENTIAL EFFECTS OF SURFACTANT THERAPY ON SURVIVAL IN THE EXTREMELY LOW BIRTH WEIGHT INFANT: A WHITE MALE ADVANTAGE? 1656

Comparisons between 1 year survival rates among extremely low birth weight infants (ELBW, <1000 g) at a large tertiary perinatal center, in 1984(n=81) and 1994 (n=100), showed a global improvement for females, 46% vs. 68%(p <.05) and males, 39% vs. 68% (p <.01). Race comparisons revealed significant improvement for white ELBW infants, 50% vs. 78% (p <.01) but not for non-whites (42% vs. 52%). Race and gender comparisons revealed a significant improvement for white males, 41% vs. 80% (p <.01) but improvements were not significant for white females, nor non-white females or males. For the subgroup of smallest infants (<751 g) significant improvement occurred for females overall, 31% vs.61% (p <.01), white infants, 19% vs. 67% (p <.01), and white males, 11% vs. 67%, (p <.05) but was not significantly improved for males overall, non-white males or females or white females. The major change in care was uniform use of surfactant therapy in all ELBW infants in 1994 and no surfactant use in 1984. Race and gender comparisons among 1994 infants only revealed a significant survival difference between males based on race. 80% of white males <1000 g vs.41% of non-white males survived (p <.01) while 67% of white males<751 g survived vs.11% of non-white males, (p <.05). Other 1994 race and gender comparisons revealed no significant differences. CONCLUSION: While survival rates of ELBW infants generally improved over a 10 year period with the routine use of surfactant therapy, it appears preferentially beneficial to white male infants whose survival rates at our institution have gone from lowest to highest in these weight groups.

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(Spon. By W. P. Zeller)

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Sajous, C., Halsey, C., Weiss, M. et al. DIFFERENTIAL EFFECTS OF SURFACTANT THERAPY ON SURVIVAL IN THE EXTREMELY LOW BIRTH WEIGHT INFANT: A WHITE MALE ADVANTAGE? 1656. Pediatr Res 39, 279 (1996). https://doi.org/10.1203/00006450-199604001-01680

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