Increased antenatal glucocorticoid use decreases mortality and morbidity in the NICHD Neonatal Research Network's very low birth weight (VLBW) infants.• 1269

Improvements in quality of care have led to a significant reduction in mortality and morbidity in preterm infants, especially very-low-birth-weight (VLBW) infants [...]

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Assessing the Effectiveness of Care for Very Low Birth Weight Infants—Do We Really Need Population-Based Data?

PEDIATRICS ◽

10.1542/peds.84.5.912 ◽

1989 ◽

Vol 84 (5) ◽

pp. 912-913

Author(s):

KIRSTI M. HEINONEN

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Population Based ◽

Low Birth Weight Infants ◽

Large Hospital ◽

Mortality And Morbidity ◽

Vlbw Infants ◽

Additional Information ◽

Randomized Controlled Clinical Trials

The active and vigorous care now provided for even the smallest infants has reduced both mortality and morbidity among very low birth weight (VLBW, birth weight <1500 g) infants. The efficacy of individual therapeutic elements has been documented as a part of this management, in some cases by randomized controlled clinical trials. Thus the present practices of providing respiratory, nutritional, and environmental support for VLBW infants seem to be well supported by experimental evidence, usually derived from large hospital-based experience. What—if any—additional information can be gained by relating the outcome of VLBW infants to geographic data covering all such births? In the present commentary, an attempt is made to answer this question by focusing first on two important aspects, namely, the availability and overall effectiveness of intensive care services for VLBW infants.

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Preventing Admission Hypothermia in Very Low Birth Weight Neonates

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.33.3.143 ◽

2014 ◽

Vol 33 (3) ◽

pp. 143-149 ◽

Cited By ~ 8

Author(s):

Kristin Fawcett

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Heat Losses ◽

Major Contributor ◽

Body Temperatures ◽

Mortality And Morbidity ◽

Vlbw Infants ◽

Core Body ◽

Neonatal Hypothermia

Neonatal hypothermia, temperature <36.5°C, is a major contributor to neonatal mortality and morbidity. Hypothermia of preterm infants remains a challenge in the NICU for many reasons. Preterm very low birth weight (VLBW) infants, those infants born <1,500 g, are prone to very rapid heat losses through mechanisms of convection, evaporation, conduction, and radiation. This article reviews current research to reduce and prevent mortality and morbidity from hypothermia in preterm VLBW infants by implementing interventions in the delivery room to minimize heat loss and maintain core body temperatures.

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Outcomes of neonatal hypothermia among very low birth weight infants: a Meta-analysis

Maternal Health Neonatology and Perinatology ◽

10.1186/s40748-021-00134-6 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Sagad Omer Obeid Mohamed ◽

Sara Mohamed Ibrahim Ahmed ◽

Reem Jamal Yousif Khidir ◽

Mutaz Tarig Hassan Ahmed Shaheen ◽

Mosab Hussen Mostafa Adam ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Meta Analysis ◽

Grey Literature ◽

World Health ◽

Cochrane Library ◽

Mortality And Morbidity ◽

Vlbw Infants ◽

Pooled Prevalence

Abstract Background Neonatal admission hypothermia (HT) is a frequently encountered problem in neonatal intensive care units (NICUs) and it has been linked to a higher risk of mortality and morbidity. However, there is a disparity in data in the existing literature regarding the prevalence and outcomes associated with HT in very low birth weight (VLBW) infants. This review aimed to provide further summary and analyses of the association between HT and adverse clinical outcomes in VLBW infants. Methods In July 2020, we conducted this review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic database search was conducted in MEDLINE (PubMed), Google Scholar, ScienceDirect, World Health Organization Virtual Health Library, Cochrane Library databases, and System for Information on Grey Literature in Europe (SIGLE). We included studies that assessed the prevalence of HT and/or the association between HT and any adverse outcomes in VLBW infants. We calculated the pooled prevalence and Odds Ratio (OR) estimates with the corresponding 95% Confidence Interval (CI) using the Comprehensive meta-analysis software version 3.3 (Biostat, Engle-wood, NJ, USA; http://www.Meta-Analysis.com). Results Eighteen studies that fulfilled the eligibility criteria were meta-analyzed. The pooled prevalence of HT among VLBW infants was 48.3% (95% CI, 42.0–54.7%). HT in VLBW infants was significantly associated with mortality (OR = 1.89; 1.72–2.09), intra-ventricular hemorrhage (OR = 1.86; 1.09–3.14), bronchopulmonary dysplasia (OR = 1.28; 1.16–1.40), neonatal sepsis (OR = 1.47; 1.09–2.49), and retinopathy of prematurity (OR = 1.45; 1.28–1.72). Conclusion Neonatal HT rate is high in VLBW infants and it is a risk factor for mortality and morbidity in VLBW infants. This review provides a comprehensive view of the prevalence and outcomes of HT in VLBW infants.

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Reduced Formula Intake with Donor Milk (DM) Impacts Necrotizing Enterocolitis (NEC) in Very Low Birth Weight (VLBW) Infants:

PEDIATRICS ◽

10.1542/peds.137.supplement_3.443a ◽

2016 ◽

Vol 137 (Supplement 3) ◽

pp. 443A-443A

Author(s):

Jennifer S. Wicks ◽

Anita L. Esquerra-Zwiers ◽

Laura M. Rogers ◽

Celina M. Scala ◽

Shirley Chen ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Necrotizing Enterocolitis ◽

Very Low Birth Weight ◽

Donor Milk ◽

Vlbw Infants

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Comparison of Mortality and Morbidity of Very Low Birth Weight Infants Between Canada and Japan

PEDIATRICS ◽

10.1542/peds.2012-0336d ◽

2012 ◽

Vol 130 (4) ◽

pp. X38-X38

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Mortality And Morbidity

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Sex-Specific Long-Term Trends in Length of Hospital Stay, Postmenstrual Age at Discharge, and Survival in Very Low Birth Weight Infants

Neonatology ◽

10.1159/000515899 ◽

2021 ◽

pp. 1-9

Author(s):

Matthias Fröhlich ◽

Tatjana Tissen-Diabaté ◽

Christoph Bührer ◽

Stephanie Roll

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Hospital Stay ◽

Very Low Birth Weight ◽

Survival Rates ◽

Length Of Hospital Stay ◽

Mortality Rates ◽

Vlbw Infants ◽

Postmenstrual Age ◽

Over Time

Introduction: In very low birth weight (<1,500 g, VLBW) infants, morbidity and mortality have decreased substantially during the past decades, and both are known to be lower in girls than in boys. In this study, we assessed sex-specific changes over time in length of hospital stay (LOHS) and postmenstrual age at discharge (PAD), in addition to survival in VLBW infants. Methods: This is a single-center retrospective cohort analysis based on quality assurance data of VLBW infants born from 1978 to 2018. Estimation of sex-specific LOHS over time was based on infants discharged home from neonatal care or deceased. Estimation of sex-specific PAD over time was based on infants discharged home exclusively. Analysis of in-hospital survival was performed for all VLBW infants. Results: In 4,336 of 4,499 VLBW infants admitted from 1978 to 2018 with complete data (96.4%), survival rates improved between 1978–1982 and 1993–1997 (70.8 vs. 88.3%; hazard ratio (HR) 0.20, 95% confidence interval 0.14, 0.30) and remained stable thereafter. Boys had consistently higher mortality rates than girls (15 vs. 12%, HR 1.23 [1.05, 1.45]). Nonsurviving boys died later compared to nonsurviving girls (adjusted mean survival time 23.0 [18.0, 27.9] vs. 20.7 [15.0, 26.3] days). LOHS and PAD assessed in 3,166 survivors displayed a continuous decrease over time (1978–1982 vs. 2013–2018: LOHS days 82.9 [79.3, 86.5] vs. 60.3 [58.4, 62.1] days); PAD 40.4 (39.9, 40.9) vs. 37.4 [37.1, 37.6] weeks). Girls had shorter LOHS than boys (69.4 [68.0, 70.8] vs. 73.0 [71.6, 74.4] days) and were discharged with lower PAD (38.6 [38.4, 38.8] vs. 39.2 [39.0, 39.4] weeks). Discussion/Conclusions: LOHS and PAD decreased over the last 40 years, while survival rates improved. Male sex was associated with longer LOHS, higher PAD, and higher mortality rates.

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Predictors of Mortality Among Very Low Birth Weight Infants With Gastrointestinal Perforation

The American Surgeon ◽

10.1177/0003134820956928 ◽

2020 ◽

pp. 000313482095692

Author(s):

Marina L. Reppucci ◽

Eliza H. Hersh ◽

Prerna Khetan ◽

Brian A. Coakley

Keyword(s):

Metabolic Acidosis ◽

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Severe Metabolic Acidosis ◽

Related Factors ◽

Vlbw Infants ◽

Risk Of Death ◽

Portal Venous Gas ◽

Elevated Lactate

Background Gastrointestinal (GI) perforation is a risk factor for mortality in very low birth weight (VLBW) infants. Little data exist regarding pretreatment factors and patient characteristics known to independently correlate with risk of death. Materials and Methods A retrospective review of all VLBW infants who sustained GI perforation between 2011 and 2018 was conducted. Birth, laboratory, and disease-related factors of infants who died were compared to those who survived. Results 42 VLBW infants who sustained GI perforations were identified. Eleven (26.19%) died. There were no significant differences in birth-related factors, hematological lab levels at diagnosis, presence of pneumatosis, or bacteremia. Portal venous gas ( P = .03), severe metabolic acidosis ( P < .01), and elevated lactate at diagnosis ( P < .01) were statistically more likely to occur among infants who died. Discussion Portal venous gas, severe metabolic acidosis, and elevated lactate were associated with an increased risk of mortality among VLBW infants who develop a GI perforation. Further research is required to better identify risk factors.

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Prevalence and predictors of adverse outcomes in neonatal seizures

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-200499 ◽

2021 ◽

pp. 1-7

Author(s):

K. Famra ◽

P. Barta ◽

A. Aggarwal ◽

B.D. Banerjee

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Birth Asphyxia ◽

Adverse Outcomes ◽

Neonatal Seizures ◽

Clinical Practices ◽

Inborn Errors ◽

Mortality And Morbidity ◽

Low Birth Weight Babies

OBJECTIVES: Neonatal seizures are significant cause of neonatal mortality and morbidity. Current study was planned to study prevalence of adverse outcomes in neonatal seizures and identify its predictors. METHODS: This observational descriptive study was carried out on 220 neonates with seizures. Neonates who succumbed to illness/ death before investigations, or whose maternal records were incomplete were excluded. Blood sugar, serum calcium, serum electrolytes, and USG skull were done in all patients. CT scan, MRI and inborn errors of metabolism profile were done as and when indicated. Adverse outcomes were defined as death, phenobarbitone non responders, or abnormal examination at discharge. Antenatal, perinatal and neonatal predictors of adverse outcomes in neonatal seizures were evaluated. RESULTS: Out of 220 neonates with seizures 76(34.5%) had adverse outcomes. Very low birth weight babies (≤1500 gm) [OR 1.27(CI 0.57–2.84)], microcephaly [OR 5.93 (CI 0.55–64.41)], Apgar score≤3 at 5 minutes [OR 11.28(CI 14.18–30.45)], seizure onset within 24 hours [OR 5.99(CI 12.43–14.78)], meningitis [OR 2.63(CI 0.08–6.39)], septicemia [OR1.22(CI 0.45–3.31)] and abnormal cranial USG [OR 7.95(CI 12.61–24.22)] were significant predictors of adverse outcomes in neonates with seizures. CONCLUSION: Prematurity, very low birth weight, birth asphyxia, meningitis, septicemia and abnormal USG could predict adverse outcomes in neonatal seizures. Improved antenatal and neonatal clinical practices may help reduce adverse outcomes in these patients.

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