Improved outcome in very low birth weight infants from 1977 to 1983

Abstract

Changes of mortality and neurological morbidity in 351 very low birth-weight infants cared for in the neonatal intensive care unit of the Children's Hospital Tübingen during the years 1977 to 1983 are reported. The main finding was a survival rate increasing from 69.5% in 1977-79 to 76.6% in 1982-83 and a coinciding frequency of severe neurological sequelae decreasing from 9.2%-3.7%. The incidence of minor neurodevelopmental problems remained unchanged. However, mortality after discharge was found to be increased during the period observed. In conclusion, the intensification of neonatal intensive care in our hospital did not only reduce mortality but also the rate of severe neurological sequelae, thus not only survival rate but also the quality of survival could be improved.

Obstetrical and neonatal risk factors in very low birth weight infants related to their neurological development

“…The assessment of risk factors in surviving VLBW infants born in the years [1977][1978][1979][1980][1981][1982][1983] showed that the decreasing incidence of neurological handicaps found in this population [5] was accompanied by a decreasing obstetrical and neonatal risk. Evidently, this improvement was facilitated by earlier obstetrical intervention, e.g.…”

“…Children with major handicaps (cerebral palsy, severe mental retardation, severe vision loss, severe hearing loss) and children with normal development were identified in a follow-up study of VLBW infants treated in our NICU during the years 1977-1983 [5].…”

Neurologische Basisuntersuchung für das Alter von 0–2 Jahren

“…Da die Tübinger Abteilung in enger Kooperation mit der Abteilung Neonato logie der Klinik über eine dreißigjährige Erfahrungen mit Nachuntersuchungen von Kindern mit neurologischen Auffäl ligkeiten z. T. bis in das Schulalter hinein verfügt [1,10,11,15,16,17] ............................................. .............................................. …”

Das Transportproblem — Transport in utero gegen Transport des Neugeborenen

“…Reanimation und Transport durch geschutte P~idiater verbessert die Aussichten kl6iner Frfihgeborener betrfichtlich: Sie werden ebenso hfiufig primfir.inmbiert wie im Perinatalzentrum [35] [11]. Vergleichende Langzeituntersuchungen yon in utero-undpostnatal-transportierten Neugeborenen liegen nut von Frfihgeborenen <i006 g vor [17].…”

“…Wiederum sind die Unterschiede bei extrem kleinen Frfihgeborenen nicht immer signifikant. Mit weiterer Abnahme der Sterblichkeit ist jedoch auch bei diesen Kindern ein Effekt des Transportmodus zu erwarten [11].…”