Risk Factors Associated with Infant Death Among Very Low Birth Weight Infants After Discharge from an Intensive Care Nursery

Purpose. Cryotherapy for retinopathy of prematurity (ROP) is effective in reducing the incidence of blindness in premature infants. However, macular complications associated with successful treatment have not yet been well studied. Methods. Eighteen very low birth weight (<1251 g) infants (32 eyes) who received cryotherapy for ROP were examined serially for regression of disease and for development of macular abnormalities. Patient characteristics and treatment factors were evaluated to identify risk factors associated with the development of macular abnormalities after successful cryotherapy. Results. Eleven of 32 eyes (34.4%) that had undergone cryotherapy developed significant macular abnormalities, including macular coloboma-like change (six eyes), macular hyperpigmentation (two eyes), irregularly mottled macular hyperpigmentation and hypopigmentation (two eyes), and macular hyperpigmentation and hypopigmentation with subretinal proliferation (one eye). Corrected visual acuity in affected eyes ranged from 0.15 to 0.03 (20/133 to 20/666) compared with 1.0 to 0.2 (20/20 to 20/100) in treated eyes without macular abnormality (P = .0002). No difference in gestational age was noted between infants who did or did not develop macular coloboma-like lesions or pigment abnormalities. Eyes with macular abnormality had more posterior disease (P = .037) and received significantly more cryotherapy than did eyes without macular abnormality (P = .0005). Conclusions. In very low birth weight infants receiving cryotherapy for ROP, development of macular coloboma-like lesions and macular pigment abnormalities were related to greater severity of ROP and a greater amount of cryotherapy. Macular abnormalities were associated with markedly worse visual outcomes than were treated eyes without macular abnormality.

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Factors Associated With Breastfeeding Very Low Birth Weight Infants at Neonatal Intensive Care Unit Discharge: A Single-Center Brazilian Experience

Journal of Human Lactation ◽

10.1177/0890334420981929 ◽

2020 ◽

pp. 089033442098192

Author(s):

Mariana González de Oliveira ◽

Desirée de Freitas Valle Volkmer

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Factors Associated ◽

Breastfeeding Rates

Background The mothers of very low birth weight infants face many challenges to achieve breastfeeding at hospital discharge, especially during long stays. Research aim The aim of this study was to describe the incidence and factors associated with breastfeeding rates (exclusive or with formula) at discharge, for very low birth weight infants, in a private Neonatal Intensive Care Unit in southern Brazil. Methods We conducted a prospective longitudinal cohort study of infants ( N = 335) with very low birth weight and/or less than 30 weeks gestational age, who survived to discharge and had no contraindication to mother’s own milk. Participants were initially divided into three groups (exclusive breastfeeding, some breastfeeding, and no breastfeeding) based on their feedings at discharge; however, later, two groups were analyzed (any breastfeeding, no breastfeeding). Results Most (93.4%; n = 313) were breastfeeding directly at least once daily at discharge, of which 16.1% ( n = 54) were receiving exclusive mother’s milk and 77.3% ( n = 259) mixed feeding (mother’s milk and formula). Breastfeeding at discharge was associated with gestational age ≥ 28 weeks, higher birth weight, not developing neonatal sepsis or bronchopulmonary dysplasia during the hospital stay, shorter lengths of stay, and lower weight at discharge. After Poisson regression, breastfeeding at discharge was associated only with a shorter length of stay (RR 0.98; CI 95% [0.95, 0.99], p < .05). Conclusions In our single unit experience in Brazil, most infants were breastfeeding at discharge. NICU staff might address mothers of infants who have prolonged hospitalization with specific strategies. Mothers and infants at risk can be identified early and personalized interventions can be developed for improving breastfeeding rates at discharge.

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Risk factors associated with post-hemorrhagic hydrocephalus among very low birth weight infants of 24–28 weeks gestation

Journal of Perinatology ◽

10.1038/jp.2016.18 ◽

2016 ◽

Vol 36 (7) ◽

pp. 557-563 ◽

Cited By ~ 4

Author(s):

G Klinger ◽

◽

M Osovsky ◽

V Boyko ◽

N Sokolover ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Factors Associated

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Risk Factors Associated With The Need For A Tracheostomy In Very Low Birth Weight Infants.

10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a6232 ◽

2010 ◽

Author(s):

Ajith K. Mathew ◽

Anne Worth ◽

Maroun J. Mhanna

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Factors Associated

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Maternal Risks for Very Low Birth Weight Infant Mortality

PEDIATRICS ◽

10.1542/peds.98.2.236 ◽

1996 ◽

Vol 98 (2) ◽

pp. 236-241

Author(s):

Tracey Sumits ◽

Robert Bennett ◽

Jeffrey Gould

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Infant Mortality ◽

Low Birth Weight ◽

Infant Death ◽

Very Low Birth Weight ◽

Maternal Risk Factors ◽

Low Birth Weight Infants ◽

Maternal Risk ◽

Planned Pregnancy

Objective. To determine whether known maternal risk factors for low birth weight directly contribute to infant mortality among very low birth weight infants. Design. Retrospective population-based, case-control study. Setting. Four hospitals in the Oakland, California, area: one community, two private, one health maintenance organization. Participants. All live-born singleton very low birth weight (<1500 g) infants born to Oakland residents over a 3-year period. Cases were infants who died before their first birthday, identified by computerized linkage of birth and death certificates. For each case, a surviving control was selected to match for birth weight, sex, and race. Forty matched pairs were identified in total. Outcome Measures. Prevalence of maternal risk factors among cases versus controls. Results. After controlling for other factors known to influence either birth weight or infant mortality, maternal cocaine use (odds ratio [OR] = 5.43), prior infant death (OR = 27.14), and planned pregnancy (OR = 6.33) were significantly associated with the survival of very low birth weight infants. Conclusions. Some maternal risk factors for low birth weight confer a survival advantage to very low birth weight infants. Our data reveal that maternal cocaine use is independently associated with survival among this subset of infants. Prior research supports the observed relationship as well as the scientific plausibility of a cocaine-mediated survival advantage among premature infants. Our study also showed both planned pregnancy and prior infant death to be independently associated with infant survival among this subset of infants, sugesting that maternal behaviors may play a role in determining birth weight-specific mortality. These data should be systematically evaluated to better define their relationship to infant mortality.

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Artificial intelligence model comparison for risk factor analysis of patent ductus arteriosus in nationwide very low birth weight infants cohort

Scientific Reports ◽

10.1038/s41598-021-01640-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jae Yoon Na ◽

Dongkyun Kim ◽

Amy M. Kwon ◽

Jin Yong Jeon ◽

Hyuck Kim ◽

...

Keyword(s):

Artificial Intelligence ◽

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Patent Ductus Arteriosus ◽

Very Low Birth Weight ◽

Ductus Arteriosus ◽

Low Birth Weight Infants ◽

Factors Associated ◽

Patent Ductus

AbstractDespite the many comorbidities and high mortality rate in preterm infants with patent ductus arteriosus (PDA), therapeutic strategies vary depending on the clinical setting, and most studies of the related risk factors are based on small sample populations. We aimed to compare the performance of artificial intelligence (AI) analysis with that of conventional analysis to identify risk factors associated with symptomatic PDA (sPDA) in very low birth weight infants. This nationwide cohort study included 8369 very low birth weight (VLBW) infants. The participants were divided into an sPDA group and an asymptomatic PDA or spontaneously close PDA (nPDA) group. The sPDA group was further divided into treated and untreated subgroups. A total of 47 perinatal risk factors were collected and analyzed. Multiple logistic regression was used as a standard analytic tool, and five AI algorithms were used to identify the factors associated with sPDA. Combining a large database of risk factors from nationwide registries and AI techniques achieved higher accuracy and better performance of the PDA prediction tasks, and the ensemble methods showed the best performances.

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