The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2003
Outcome of very-low-birth-weight infants in a developing country: a prospective study from the western region of Turkey.
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Duman N, Kumral A, Gülcan H, Ozkan H
Аннотация
OBJECTIVE: To illustrate neonatal outcomes, including morbidity, birth weight and gestational age-specific mortality, and care practices for very-low-birth-weight infants admitted to our tertiary neonatal intensive care unit in Turkey and compare these with the corresponding data from recent reports from developed countries.
METHODS: Perinatal data were collected prospectively from January 1996 to December 2000. Perinatal events and the neonatal course to 120 days of life, discharge, or death were evaluated.
RESULTS: Of 173 infants, 82% survived until discharge to home or to 120 days of life. Survival was 13% for infants of 501-750 g at birth, 74% for those of 751-1000 g, 92% for those of 1001-1250 g and 87% for those of 1251-1500 g. Mortality rates were greater for male than for female infants (25% vs. 12%). The mean birth weight was 1218 (450-1500) g and the mean gestational age was 29.8 (23-36) weeks. The birth weight and gestational age distributions showed that the majority of infants (48%) weighed 1251-1500 g and were between 28 and 31 weeks' gestation (57%). Antenatal steroids were administered to only 19% of mothers. The overall Cesarean section rate was 77%. Respiratory distress syndrome was diagnosed in 36% and surfactant was administered to 98% of these infants. The rate of ventilator support was 54% for a mean duration of 9 days. Air leak syndromes were diagnosed in only nine infants (5%). Severe intracranial hemorrhage (grade > II) and periventricular leukomalacia developed in 9% of infants. Four infants had evidence of chronic lung disease. Retinopathy of prematurity (stage > II) was noted in only one infant, and proven necrotizing enterocolitis (Bell's classification stage > 2) was not observed. The rate of survival without major morbidity was 91%. The mean hospital stay was 40 days for survivors and 19 days for infants who died.
CONCLUSION: Despite marked differences in socioeconomic conditions and tertiary care facilities, the mortality (except in the smallest babies) and morbidity rates were comparable with those of recent studies from developed countries.
METHODS: Perinatal data were collected prospectively from January 1996 to December 2000. Perinatal events and the neonatal course to 120 days of life, discharge, or death were evaluated.
RESULTS: Of 173 infants, 82% survived until discharge to home or to 120 days of life. Survival was 13% for infants of 501-750 g at birth, 74% for those of 751-1000 g, 92% for those of 1001-1250 g and 87% for those of 1251-1500 g. Mortality rates were greater for male than for female infants (25% vs. 12%). The mean birth weight was 1218 (450-1500) g and the mean gestational age was 29.8 (23-36) weeks. The birth weight and gestational age distributions showed that the majority of infants (48%) weighed 1251-1500 g and were between 28 and 31 weeks' gestation (57%). Antenatal steroids were administered to only 19% of mothers. The overall Cesarean section rate was 77%. Respiratory distress syndrome was diagnosed in 36% and surfactant was administered to 98% of these infants. The rate of ventilator support was 54% for a mean duration of 9 days. Air leak syndromes were diagnosed in only nine infants (5%). Severe intracranial hemorrhage (grade > II) and periventricular leukomalacia developed in 9% of infants. Four infants had evidence of chronic lung disease. Retinopathy of prematurity (stage > II) was noted in only one infant, and proven necrotizing enterocolitis (Bell's classification stage > 2) was not observed. The rate of survival without major morbidity was 91%. The mean hospital stay was 40 days for survivors and 19 days for infants who died.
CONCLUSION: Despite marked differences in socioeconomic conditions and tertiary care facilities, the mortality (except in the smallest babies) and morbidity rates were comparable with those of recent studies from developed countries.