Posthemorrhagic Hydrocephalus: A Complication of Intraventricular Hemorrhage

SURVIVAL OF PREMATURE AND LOW birth weight (LBW) neonates has increased in the past decade, and it continues to improve with recent advances in neonatal care. The use of antenatal corticosteroids and surfactant has played a major role in the improved survival of these LBW infants. Stevenson and colleagues documented survival-to-discharge rates of 49 percent for infants weighing 501–750 gm at birth, 85 percent for those 751–1,000 gm, 93 percent for those 1,001–1,250 gm, and 96 percent for those 1,251–1500 gm. With increasing survival rates, developmental outcome remains a concern, particularly in the lowest birth weight groups. Approximately 32 percent of very low birth weight (VLBW) infants (defined as weighing 501–1,500 gm) show evidence of intracrenial hemorrhage.

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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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Single-course antenatal corticosteroids is related to faster growth in very-low-birth-weight infant

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03510-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jiajia Jing ◽

Yiheng Dai ◽

Yanqi Li ◽

Ping Zhou ◽

Xiaodong Li ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Gestational Age ◽

Very Low Birth Weight ◽

Postnatal Growth ◽

Weight Increase ◽

Antenatal Corticosteroids ◽

Lung Maturation ◽

Growth Outcomes

Abstract Background Antenatal corticosteroids (ACS) treatment is critical to support survival and lung maturation in preterm infants, however, its effect on feeding and growth is unclear. Prior preterm delivery, it remains uncertain whether ACS treatment should be continued if possible (repeated course ACS), until a certain gestational age is reached. We hypothesized that the association of single-course ACS with feeding competence and postnatal growth outcomes might be different from that of repeated course ACS in very-low-birth-weight preterm infants. Methods A multicenter retrospective cohort study was conducted in very-low-birth-weight preterm infants born at 23–37 weeks’ gestation in South China from 2011 to 2014. Data on growth, nutritional and clinical outcomes were collected. Repeated course ACS was defined in this study as two or more courses ACS (more than single-course). Infants were stratified by gestational age (GA), including GA < 28 weeks, 28 weeks ≤ GA < 32 weeks and 32 weeks ≤ GA < 37 weeks. Multiple linear regression and multilevel model were applied to analyze the association of ACS with feeding and growth outcomes. Results A total of 841 infants were recruited. The results, just in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation, showed both single and repeated course of ACS regimens had shorter intubated ventilation time compared to non-ACS regimen. Single-course ACS promoted the earlier application of amino acid and enteral nutrition, and higher rate of weight increase (15.71; 95%CI 5.54–25.88) than non-ACS after adjusting for potential confounding factors. No associations of repeated course ACS with feeding, mean weight and weight increase rate were observed. Conclusions Single-course ACS was positively related to feeding and growth outcomes in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation. However, the similar phenomenon was not observed in the repeated course of ACS regimen.

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The echographic characteristics of structural and functional development of organs and systems in children born with low birth weight, very low birth weight and extremely low birth weight

Russian Pediatric Journal ◽

10.15690/rpj.v1i3.2170 ◽

2020 ◽

Vol 1 (3) ◽

pp. 11-17

Author(s):

P. E. Khodkevich ◽

K. V. Кulikova ◽

V. V. Gorev ◽

I. A. Deev

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Negative Impact ◽

Extremely Low Birth Weight ◽

Small Children ◽

Neuropsychological Development ◽

The Past ◽

Functional Development ◽

Development Of Organs

Over the past decade, an increase in the survival rate of children born with low birth weight, very low birth weight, and extremely low birth weight has been observed in Russian Federation, which is due to transition to new live birth criteria. Premature infants are exposed to a number of adverse factors that have a negative impact on the development of organs and systems, which, in turn, can lead to the occurrence of acute and chronic diseases in various age periods. Therefore, neonatologists and pediatricians are dealing with a new cohort of small children who have particular features of physical and neuropsychological development which may lead to severe debilitating diseases. This review article surveys previous studies evaluating the echographic characteristics of structural and functional development of the urinary, cardiovascular and endocrine systems as a function of body weight at birth and gestational age, and in different age periods.

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28-Day Survival Rates of 6676 Neonates With Birth Weights of 1250 Grams or Less

PEDIATRICS ◽

10.1542/peds.87.1.7 ◽

1991 ◽

Vol 87 (1) ◽

pp. 7-17

Author(s):

Dale L. Phelps ◽

David R. Brown ◽

Betty Tung ◽

George Cassady ◽

Richard E. McClead ◽

...

Keyword(s):

Multivariate Analysis ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Small For Gestational Age ◽

Very Low Birth Weight ◽

Survival Rates ◽

Survival Advantage ◽

Lower Birth Weight ◽

Single Birth

Survival rates specific for birth weight, gestational age, sex, and race are described for 6676 inborn neonates who weighed less than 1251 g at birth and were born during 1986 through 1987. Overall 28-day survival increased with gestational age and birth weight, from 36.5% at 24 weeks' gestation to 89.9% at 29 weeks' gestation, or from 30.0% for neonates of 500 through 599 g birth weight to 91.3% for neonates of 1200 through 1250 g. The expected birth weight-specific survival advantage for female neonates and black neonates diminished when the data were controlled for gestational age, showing that certain previously reported survival advantages are based on lower birth weight for a given gestational age. Multivariate analysis showed that all tested variables were significant predictors for survival, in order of descending significance: gestational age and birth weight, sex, race, single birth, and small-for-gestational-age status. The powerful effect of gestational age on survival highlights the need for an accurate neonatal tool to assess the gestational age of very low birth weight neonates after birth.

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Effects of Antenatal Corticosteroids on Neonatal Outcomes in Very-Low-Birth-Weight Preterm Newborns: A 10-Year Retrospective Study in a Medical Center

Pediatrics & Neonatology ◽

10.1016/j.pedneo.2012.04.004 ◽

2012 ◽

Vol 53 (3) ◽

pp. 178-183 ◽

Cited By ~ 5

Author(s):

Ya-Chen Wang ◽

Hsing-I. Tseng ◽

San-Nan Yang ◽

Chu-Chong Lu ◽

Jiunn-Ren Wu ◽

...

Keyword(s):

Retrospective Study ◽

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Medical Center ◽

Neonatal Outcomes ◽

Antenatal Corticosteroids ◽

Preterm Newborns

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Exploratory Laparotomy for Necrotizing Enterocolitis

10.1093/med/9780199764495.003.0051 ◽

2013 ◽

Author(s):

Dugald McAdam

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Necrotizing Enterocolitis ◽

Very Low Birth Weight ◽

Survival Rates ◽

Exploratory Laparotomy ◽

Extremely Low Birth Weight ◽

Life Threatening Illness ◽

Antenatal Steroids ◽

Neonatal Lung

The survival rates of very-low-birth weight (VLBW; birth weight <1,500 g) and extremely-low-birth weight (ELBW; birth weight <1,000 g) infants have increased with improvements in antenatal and postnatal care. These include the use of antenatal steroids, artificial surfactant, and ventilation strategies that have reduced injury to the neonatal lung. As a result, the pediatric anesthesiologist is now more often faced with the task of safely caring for these infants, often in unfamiliar environments, and sometimes during episodes of life-threatening illness. One example is necrotizing enterocolitis (NEC) requiring surgical management.

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Recém-Nascido de Muito Baixo Peso numa Unidade de Cuidados Intensivos Portuguesa Comparativamente ao Vermont Oxford Network: 15 Anos de Registo

Acta Médica Portuguesa ◽

10.20344/amp.9130 ◽

2019 ◽

Vol 32 (11) ◽

pp. 686

Author(s):

Joana Saldanha ◽

Carlos Moniz ◽

Maria do Céu Machado

Keyword(s):

Birth Weight ◽

Length Of Stay ◽

Low Birth Weight ◽

Gestational Age ◽

Low Birthweight ◽

Very Low Birth Weight ◽

Post Partum ◽

Ductus Arteriosus ◽

Corticosteroid Treatment ◽

The Past

Introduction: Our neonatal service is part of a differentiated perinatal hospital and has contributed to the Vermont Oxford Network for more than 15 years. This data base includes data on the morbidity and mortality of newborns born in the member hospitals with birth weight between 401 and 1500 g and/ or from 22 to 29 weeks and six days of gestation, or those admitted to these hospitals with up to 28 days of age. It thus allows the analysis of clinical practice and its comparison with similar units. The goal of the present paper is to disclose some of our data from the past 15 years and to compare it with the Vermont Oxford Network data trying to identify areas of possible improvement and permitting other neonatal units to compare their data with our in a benchmarking process.Material and Methods: Observational, retrospective study. It included newborns with birth weight ≤ 1500 g (very low birth weight newborns) born and treated at our hospital from 2001 to 2015. Descriptive data analysis, chi-square test and ANOVA, significance when p < 0.05.Results: A total of 869 very low birth weight newborns were studied, median weight 1100 g and gestational age 29 weeks. Twinning was found in 37.6%. In the delivery room, 23% did not require any resuscitation, 52.2% of the newborns required invasive intubation, 78.3% had surfactant, and, since 2011, 29.7% have started noninvasive ventilation. Of the total very low birth weight newborns, 12.9% had oxygen therapy at 36 weeks of corrected age, 23% patent ductus arteriosus and late sepsis in 17.1%. There was higher neurological morbidity compared to the Vermont Oxford Network except in the case of retinopathy of prematurity. Overall mortality was 14% (122 newborns). The time of hospitalization was on average 52.7 ± 34.4 days. The 629 newborns that were discharged home had equivalent length of stay and head circumference measure but a lower weight than those in the Vermont Oxford Network, and 14.3% went home with exclusive breastfeeding.Discussion: This work allowed us to study our very low birth weight newborns data and compare it with one of the largest neonatal world networks. Our population is similar from the point of view of gestational age, somatometric data, pregnancy surveillance rates and cesarean section with the most noticeable difference being the percentage of low birthweight for gestational age babies, twin pregnancies and antenatal corticosteroid treatment, superior in our center. Cardio-pulmonary and gastrointestinal disorders were overlapping. It is urgent to improve our rate of sepsis, neurologic sequelae, post-partum hypothermia control and neuroprotection with magnesium sulphate. The mortality rate and the length of stay at discharge was similar.Conclusion: This study allowed us to compare our population of very low birth weight newborns with those registered in the network. We have verified that we have been accompanying the evolution of Neonatology over the past years and we have identified areas for improvement.

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Letters to the Editor

PEDIATRICS ◽

10.1542/peds.64.4.550a ◽

1979 ◽

Vol 64 (4) ◽

pp. 550-550

Author(s):

Richard L. Schreiner

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Enteral Feeding ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Letters To The Editor ◽

The Past

We concur with Babson and Reynolds that the volume of feeding in the first few weeks of life in very low birth weight infants is probably an important factor in the etiology of lactobezoar formation. We would certainly agree with their policy of increasing the volume of enteral feeding very gradually, but we doubt that limiting the total volume to 150 to 160 ml/kg/day until nipple feedings are established will prevent lactobezoar formation since 13 of our 17 cases of infants with lactobezoars in the past three years were receiving less than 160 ml/kg/day.

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