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Pediatr Res. 2012 Nov;72(5):531-8. doi: 10.1038/pr.2012.114. Epub 2012 Aug 24.

Trends in morbidity and mortality among very-low-birth-weight infants from 2003 to 2008 in Japan.

Author information

1
Department of Neonatology, Maternal and Perinatal Center, Tokyo Women's Medical University, Tokyo, Japan. skusuda@boshi.twmu.ac.jp

Abstract

BACKGROUND:

Although medical care for very-low-birth-weight (VLBW) infants has improved over time, it is unclear how this has affected mortality and morbidity. To characterize these trends, a network database was analyzed.

METHODS:

This is a cohort study of VLBW infants born from 2003 through 2008.

RESULTS:

Over the 6-y period, 19,344 infants were registered and analyzed. Crude mortality rates among the infants at discharge decreased significantly (from 10.8 to 8.7%) during the study period. The greatest improvement in mortality was observed among infants with birth weights between 501 and 750 g (25.6-17.7 %). The odds ratio (OR) of mortality over year adjusted for potential confounders by a logistic regression model was 0.94 (95% confidence interval 0.92-0.97). Significant increases were observed in some morbidities, including symptomatic patent ductus arteriosus with an OR of 1.11 (1.09-1.13); late-onset adrenal insufficiency, 1.21 (1.17-1.26); and necrotizing enterocolitis/intestinal perforation, 1.10 (1.01-1.12). However, the severe form of intraventricular hemorrhage, with an OR of 0.98 (0.92-0.99), decreased significantly. Risk-adjusted trends in other morbidities showed no significant change.

CONCLUSION:

Mortality of VLBW infants decreased significantly over the 6-y study period. Decreasing morbidity is essential for further improvement in the outcomes in VLBW infants.

PMID:
22922774
PMCID:
PMC3547175
DOI:
10.1038/pr.2012.114
[Indexed for MEDLINE]
Free PMC Article

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