Jobe AH, Caplan MS, Fanaroff AA, Donovan EF, Bridges K, Alexander B, Grisby C, Mersmann MW, Mincey HL, Hessling J, Cotten CM, Auten KJ, Lohmeyer MB, Carlton DP, Blackwelder AM, Tidwell M, Archer SW, Lemons JA, Appel DD, Herron DE, Miller LC, Richard L, Wilson LD, Hamer F, Poole WK, Hastings BK, McClure EM, O'Donnell Auman J, Huitema CP, Zaterka-Baxter KM, Stevenson DK, Adams MM, Ball MB, Proud MS, Palmquist AW, MacKinnon BL, Nylen E, Collins MV, Cosby SS, Rasmussen MR, Wozniak PR, Arnell K, Demetrio C, Henderson C, Rich W, Widness JA, Johnson KJ, Everett-Thomas R, Backstrom Lacy C, Reubens LJ, Burnell E, Korones SB, Laptook AR, Rosenfeld CR, Salhab WA, Hensley G, Leps MH, Miller NA, Tyson JE, Akpa EG, Cluff PA, Lis AE, McDavid GE, Franco CI, Harris BF, Martin S, Simmons MC, Tate PP, Yoder BA, Osborne KA, Jensen JJ, Spencer C, Weaver-Lewis K, Dillard RG, Peters NJ, Bara R, Muran G, Oh W, Hensman AM, Gettner P, Konstantino M, Poulsen J, Taft J.
Source
Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, 2015 Uppergate Dr, Atlanta, GA 30322, USA. barbara_stoll@oz.ped.emory.edu
Abstract
OBJECTIVE:
This report presents data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network on care of and morbidity and mortality rates for very low birth weight infants, according to gestational age (GA).
METHODS:
Perinatal/neonatal data were collected for 9575 infants of extremely low GA (22-28 weeks) and very low birth weight (401-1500 g) who were born at network centers between January 1, 2003, and December 31, 2007.
RESULTS:
Rates of survival to discharge increased with increasing GA (6% at 22 weeks and 92% at 28 weeks); 1060 infants died at <or=12 hours, with most early deaths occurring at 22 and 23 weeks (85% and 43%, respectively). Rates of prenatal steroid use (13% and 53%, respectively), cesarean section (7% and 24%, respectively), and delivery room intubation (19% and 68%, respectively) increased markedly between 22 and 23 weeks. Infants at the lowest GAs were at greatest risk for morbidities. Overall, 93% had respiratory distress syndrome, 46% patent ductus arteriosus, 16% severe intraventricular hemorrhage, 11% necrotizing enterocolitis, and 36% late-onset sepsis. The new severity-based definition of bronchopulmonary dysplasia classified more infants as having bronchopulmonary dysplasia than did the traditional definition of supplemental oxygen use at 36 weeks (68%, compared with 42%). More than one-half of infants with extremely low GAs had undetermined retinopathy status at the time of discharge. Center differences in management and outcomes were identified.
CONCLUSION:
Although the majority of infants with GAs of >or=24 weeks survive, high rates of morbidity among survivors continue to be observed.