Mortality for Newborns of Birthweight less Than 1500 g in Spanish Neonatal Units (2002-2005)

Abstract

The purpose of this study was to analyze the mortality and its prognostic factors in a Spanish cohort of very low birthweight (VLBW) infants during the period 2002 to 2005. Using the Spanish Society of Neonatology database (SEN 1500), 8942 infants with a birthweight < 1500 g were recruited. The overall mortality was 17.3%. However, this incidence underwent a significant decrease over the study period, from 19.4% in 2002 to 15.2% in 2005 ( P = 0.003). Mortality ranged from 12.4% in 25% of the participating neonatal units to 19.4% in a further 25%. Mortality was higher in outborn infants (25.8%) than in inborn infants (16.6%) ( P < 0.001). The mortality rates of these neonates are also presented by 100-g intervals (401 to 1500) and for the different hospitalization times: in the delivery room, within 24 hours and 28 days of birth, at 36 weeks of postmenstrual age, and on discharge. Of note was that mortality was greatest within 24 hours and 28 days of birth in each of the weight groups ( P < 0.001). In conclusion, in the cohort of infants < 1500 g examined, mortality in the period from 2002 to 2005 was still high, especially among newborns weighing < 1000 g. We did, however, observe a decreasing trend in mortality rates for the participating neonatal units over the 4 study years. Our findings highlight the need to promote intrauterine transport and improve neonatal transport as well as the management of these infants in the delivery room and within the first 28 days of life.

Neonatal outcomes of very preterm infants admitted to a tertiary center in Lithuania between the years 2003 and 2005

“…We evaluated survival and morbidity stratified by gestational age. Our data show that overall survival rates to hospital discharge were lower compared to other recent studies, for example, the EPIPAGE study [27], the MOSAIC study [49], the study by Kusuda et al [26], or the study by Moro et al [33]. Table 6 shows a summary of mortality and shortterm outcomes for the current study in comparison with cohorts from western countries.…”

Short-term outcomes of inborn v. outborn very-low-birth-weight neonates (<1 500 g) in the neonatal nursery at Groote Schuur Hospital, Cape Town, South Africa

“…[4] Lack of antenatal steroids has been associated with lack of prenatal care and outborn status, [6] and all are statistically significant factors contributing to mortality. [7] The administration of antenatal steroids seems to be of more significance than outborn status itself, [8] and can be an independent predictor of outcome. [9] In a Canadian study enrolling >6 000 premature neonates, 37% survived without serious morbidities.…”

Perinatal factors associated with neonatal mortality in very low birth weight infants: a multicenter study

“…25 Thus, VLBW infant mortality has been reported to range between 12.4% and 28% as per the neonatal networks of developed countries (the Euro Neo Net/Euro-Peristat Network, 26 the Vermont-Oxford Network, 27 the Canadian Neonatal Network, 28 the National Institute of Child Health and Human Development [NICHD], 29 the Spanish Neonatology Society). 23 In contrast, the results obtained by the Brazilian Neonatal Research Network 30 and the Neonatology Network of Public Hospitals from the City of Buenos Aires 31 describe more unfavorable results, especially associated with a low use of antenatal corticosteroids. However, when analyzing such differences, it is necessary to consider the denominator used to estimate the mortality rate and the fact that inclusion criteria vary from one study to another, 32 in addition to differences in population, perinatal practices, and resources.…”

“…22 The RFs observed here to be independently associated with mortality are consistent with those previously described in several prediction models. 23,24 The information collected by epidemiological networks allows studying the best strategies to reduce neonatal mortality and morbidity, based on processes to improve perinatal care quality. 25 Thus, VLBW infant mortality has been reported to range between 12.4% and 28% as per the neonatal networks of developed countries (the Euro Neo Net/Euro-Peristat Network, 26 the Vermont-Oxford Network, 27 the Canadian Neonatal Network, 28 the National Institute of Child Health and Human Development [NICHD], 29 the Spanish Neonatology Society).…”