ODD of gentamicin at 4 mg/kg in neonates >/=34 weeks' gestation is the preferable treatment strategy based on: 1) significantly improved SGC performance compared with TDD; 2) elimination of the need for routine SGC collection in infants on short courses of therapy; and 3) significant antibiotic-associated hospital cost savings when compared with conventional therapy of TDD and SGC analysis.
OBJECTIVE:To determine the contribution of infants born at the threshold of viability (Ͻ750 gm) on neonatal mortality in Colorado.
STUDY DESIGN:For the period of January 1991 to December 1996, all Colorado live births who expired were evaluated for gestational age, birth weight, gender, hospital level of care, age at time of death, delivery room resuscitation, mechanical ventilation, medical and surgical complications, and serious malformations.
RESULTS:Although infants weighing Ͻ750 gm represent only 0.31% of all live births, they account for 46.3% of deaths. While those infants weighing Ͻ500 gm and with a gestation of Ͻ24 weeks almost always died (94.7%), the majority born in the 500-to 745-gm category (55.8%) survived. The vast majority (88.5%) of deaths occurred on the first day of life. A total of 38.4% of births in which the infant weighed Ͻ750 gm occurred outside bona fide regional perinatal centers.
CONCLUSION:Future attempts to reduce the Colorado neonatal mortality rate would best focus on the 500-to 750-gm weight group through the re-regionalization of high-risk perinatal care.
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