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First year mortality and hospital morbidity after newborn intensive care.

Harding JE, et al. N Z Med J. 1987.

Abstract

First year mortality and hospital morbidity were studied in 4678 surviving infants liveborn at National Women's Hospital during 1980, of whom 1113 had been admitted to the neonatal intensive care unit. Of children born there, but never admitted to the neonatal unit, 8.3% were hospitalised in their first year for a mean of 6.7 days per admission or 0.8 days per child. Hospitalisation rates were increased in neonatal unit survivors, ranging from 11.6% in normal birthweight to 15.5% in very low birthweight survivors. The hospital admissions were, on average, longer: 11 days per admission or 2.1 days per infant of low birthweight (LBW, under 2500g), and 21 days per admission or 4.8 days per infant of very low birthweight (VLBW, under 1500g). The longer averages reflected long hospital stays by only a few children. Admissions were largely for respiratory infections: no VLBW survivor was admitted for developmental delay, failure to thrive or non-accidental injury. Neonatal unit survivors had no increase in first year mortality compared with other Auckland children, and none died a cot death. Deaths in normal birthweight survivors were due to congenital abnormalities. No VLBW survivor died after discharge from National Women's Hospital. Children surviving neonatal unit care in Auckland in 1980 appeared to have less continuing first year morbidity and mortality than has been reported elsewhere.

PIP:

Researchers followed 4678 infants including 1113 admitted to the neonatal intensive care unit (NICU) born at the National Women's Hospital in 1980 in Auckland, New Zealand to determine subsequent mortality and hospital morbidity during the 1st year, 8.3% of infants born at this hospital and 7.2% of infants born at this hospital and not admitted to the NICU had been hospitalized at least once compared to 9.6% for all infants born in Auckland in 1980 (p.05 and p.001 respectively). An increased risk of subsequent hospitalization existed for infants who went to the NICU (11.7%; p.001), especially those weighing =or- 1500 g [VLBW] (15.5%; p.05). 30% of NICU infants had 1 subsequent hospitalization compared to 21.4% of all infants (p.05). Children born at this hospital and who had subsequent hospitalization averaged a 6.7 day hospitalization compared to 11 days for infants weighed 1501-2500 g (LBW) and 21.7 days for VLBW infants (both, p.001). Infections were the major reason for admissions for all groups, particularly for--VLBW infants (89.8%). The number of admission days for respiratory infections was substantially higher for NICU survivors than those not admitted to the NICU (621.7 vs. 114.4%; p.01). In addition, admission days for spina bifida/hydrocephalus for NICU survivors were significantly greater than those not admitted to the NICU (89.9 vs. 1.4; p.001). Nevertheless the median days/admission was similar for all birth weight groups. Physicians recorded feeding problems and apnea in all groups, and failure to thrive in all but the VLBW group. No NICU survivor had development delay or abnormal tone. The overall 1st year mortality rate was 5. None of the VLBW infants discharged from the NICU died during the 1st year. The highest 1st year mortality rate was for LBWs (8.6). Sudden infant death syndrome (SIDS) was responsible for 48% of all deaths. None of the NICU survivors died of SIDS. Congenital abnormalities were responsible for all deaths of NICU survivors 2500 g and 67% of all NICU survivors.

PMID

3451137 [PubMed - indexed for MEDLINE]

Erratum in

  • N Z Med J 1987 Oct 14;100(833):642.
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