No abstract

Neonatal survival of very low birth weight (VLBW) infants(600-999 grams) and long-term outcome of (LBW) infants (600-1499 grams.) are correlated w1th del1very resuscitation management were reviewed and rated. 11 0ptimal delivery care" was defined as appropriate intrapartum care and a controlled, uncomplicated delivery. 11 0ptimal resuscitation 11 required that a team be present at delivery and encounter no technical problems. Optimal delivery room (DR) management occurred when both obstetric and pediatric care were appropriate. Adequate information was available to rate 80% of cases. Survival of VLBW infants was significantly improved with optimal DR care (p < 0.05). DR care had the greatest impact on 700-999 grams infarrts. In this group, 68% of survivors had "optimal care" while only 31% of the neonatal deaths (ND) had "optimal care" (p < O.OlJ. Neonatal deaths also occurred later with optimal DR care (p < 0.02). Unavoidable obstetrical complications occurred in 14 deliveries of VLBW infants (11 ND and 3 survivors) (p < 0.05). All of the survivors had optimal resuscitation. Only 1 of the 3 survivors was normal at follow-up. Vaginal breech delivery of LBW infants had a significant neonatal mortality compared to vertex vaginal delivery (p < 0.01) or breech C-section delivery (\' < 0.02). Optimal DR management was also associated with norma long-term outcome for LBW infants. Fifty \'ercent with optimal DR care and 30% without were normal at fo low-up (p < 0.05). With improvement in Newborn Intensive Care, the effects of intrapartum and delivery room management can now be measured in both neonatal survival and long-term outcome. These findings have SEecial significance for level I who transport LBW infants after delivery and