[Mortality and prognosis of premature infants of very low birth weight (500-1,500 g) in relation to degree of maturity].

In a retrospective study we analysed the influence of intrauterine growth retardation on mortality and early prognosis of 136 liveborn singletons of very low birthweight (VLBW) born between 1986 to 1992 at the Department of Obstetrics and Gynecology of the University Hospital of Cologne. The main causes of premature delivery in the appropriate-for-gestational-age (AGA)-group were premature rupture of membranes with an incidence of 73% and in the small-for-gestational-age (SGA)-group the pregnancy induced hypertension with an incidence of 44%. With a similar mean birth weight (1,009 g vs. 1,115 g) the SGA-prematures showed a three weeks higher mean gestational age (31.3 vs. 28.3 weeks). The mortality was 10% higher in the AGA-group than in the SGA-group (30% vs 20%); as regards the whole study group the mortality showed an inverse correlation to birthweight. In the age between 11 months and 6 years severe handicaps and developmental retardations were found more often within the previous AGA-prematures with an incidence of 23% (6/26) than within the previous SGA-prematures with an incidence of 11% (4/36); the incidence and severeness of later handicap were not dependent on birthweight. Accordingly to our results mortality and early prognosis of VLBW-prematures seem to be dependent on gestational age; whereas the mortality showed an inverse correlation to birthweight, the early prognosis did not.