2-001 | Additional Comments | Previous Article | Next Article | List of Articles | Submit Comments | Index | FSN Home Page
VLBW Outcomes
Very Low Birth Weight Outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 Through December 1996. Lemons JA, Bauer CR, Oh W, et al. Pediatrics 2001; 107: e1.
Perinatal data were collected prospectively on an inborn cohort by 14 participating centers of the NICHD Neonatal Research Network and compared with corresponding data from previous reports. Survival to discharge was 84% for infants weighing 501 – 1500 grams (n=4438), compared with 80% in 1991, and 74% in 1988. Survival rate was 54% for infants 501-750 gms; 86% for 751-1000 grams; 94% for 1001-1250 grams; and 97% for 1251- 1500 grams. The incidence of CLD (23%), NEC (7%) and severe ICH (11%) remained unchanged between 1991 and 1996. 97% of VLBW infants, and 99% of infants weighing < 1000 gms at birth had weights < 10%ile at 36 weeks post menstrual age. Mortality for 195 infants weighing 401-500 grams at birth was 89%, with nearly all survivors developing CLD. Mortality for infants weighing 501-600 grams was 71%; among survivors, 62% had CLD, 35% had severe ICH, and 15% had NEC.
Comment. These data were summarized here because they provide another standard against which we can benchmark our own NICU outcomes. It was encouraging to see mortality decreasing without an increase in morbidity in survivors in VLBW babies between 1991 and 1996. This is undoubtedly due in large part to the increased use of surfactant and antenatal steroids during this period. The fact that almost all of these babies weigh <10%ile at 36 weeks PMA indicates that we need to focus more on optimal nutritional support for these babies. Perhaps this outcome variable (weight percentile at 36 weeks PMA) should be added to data that we routinely track on VLBW babies. It was also notable that there were significant differences in outcomes between hospitals, and mortality rates were significantly higher in secondary vs tertiary level hospitals (p=0.001). We might be well advised to study the protocols, policies and procedures of the NICUs with the best outcomes, and try to replicate their experience in our own units.
Date: 20 Nov 2002
Time: 16:10:38
IVH is one of the major morbidity in any nicu. We have dramatic lower incidence
of IVH (grade iii & iv ) since we adopted policy of avoidance of umblical
lines .
We use radial line and peripheral lines only (650 gm onward)
UserName: dr. qureshi
Institution: n.w.armed forces hospiatl, tabuk
email: drarifqureshi@hotmail.com
You may add your own comments to the discussion of this topic by selecting : Submit Comments.