Outcome of infants weighing 500-999 grams at birth in a Singapore hospital (1990-1993).

Over a 4-year period (1990-1993) 126 babies weighing 500-999 grams (0.39% of 32,362 livebirths) were born in the hospital that provides tertiary care. Seventy-eight babies (61.9%) were discharged alive. Survival rate (79.4% or 50/63) was higher in the larger babies (800-999 gm) than in the smaller babies (28/63 of the 500-799 gm or 44.4%, p = 0.0001). Survival rates among the 2 periods, 1990-91 (period 1) and 1992-93 (period 2) have also improved, from 44/74 or 59.5% to 34/52 or 65.4%, p = 0.62 (NS). Surfactant replacement therapy (SRT) has an impact on decreasing the mortality for babies < 1,000 gm. Only 35.3% (6/17) babies had SRT in 1993. Other perinatal factors are also contributing to a better outcome of these high risk babies. Neurodevelopmental outcome at 2 years of age of the 39 babies (50%) born in period 1 has been determined. Thirty-five percent (5/14) of the smaller babies and 28% (7/25) of the larger babies had MDI (Bayley Mental Developmental Index) of < 69. For cerebral palsy, it was 14% and 8% respectively; and for neurosensory disorder, 7% and 4% respectively. Some babies had a combination of 2 or 3 major impairments. It is estimated that 33% of babies who weighed less than 1,000 gm at birth had a disability. It was found that severe intraventricular haemorrhage (IVH) of grade III and IV correlated significantly with MDI of < 69 (p < 0.05). Severe IVH in period 2 (17.2%) did not differ significantly from that of period 1 (29.4%, p = 0.55).(ABSTRACT TRUNCATED AT 250 WORDS)