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Survival and Morbidities in Infants with Birth Weight Less than 500 g: a Nationwide Cohort Study

BACKGROUND: This study aimed to investigate the survival and morbidities of infants in the Korean Neonatal Network (KNN) with birth weight (BW) < 500 g. METHODS: The demographic and clinical data of 208 live-born infants with a BW < 500 g at a gestational age of ≥ 22 weeks who were treated in...

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Autores principales: Hwang, Ji Hye, Jung, Euiseok, Lee, Byong Sop, Kim, Ellen Ai-Rhan, Kim, Ki-Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352787/
https://www.ncbi.nlm.nih.gov/pubmed/34402234
http://dx.doi.org/10.3346/jkms.2021.36.e206
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author Hwang, Ji Hye
Jung, Euiseok
Lee, Byong Sop
Kim, Ellen Ai-Rhan
Kim, Ki-Soo
author_facet Hwang, Ji Hye
Jung, Euiseok
Lee, Byong Sop
Kim, Ellen Ai-Rhan
Kim, Ki-Soo
author_sort Hwang, Ji Hye
collection PubMed
description BACKGROUND: This study aimed to investigate the survival and morbidities of infants in the Korean Neonatal Network (KNN) with birth weight (BW) < 500 g. METHODS: The demographic and clinical data of 208 live-born infants with a BW < 500 g at a gestational age of ≥ 22 weeks who were treated in the neonatal intensive care units of the KNN between 2013 and 2017 were reviewed. RESULTS: The survival rate of the infants was 28%, with a median gestational age and BW of 24(3/7) weeks (range, 22(0/7)–33(6/7)) and 440 g (range, 220–499), respectively. Multivariable Cox proportional hazards analysis demonstrated that survival to discharge was associated with longer gestation, higher BW, female sex, singleton gestation, use of any antenatal corticosteroids, and higher Apgar scores at 5 minutes. The overall survival rates were significantly different between the BW categories of < 400 g and 400–499 g. However, there was no significant difference in the incidence of any morbidity between the BW groups. Half of the deaths of infants with BW < 500 g occurred within a week of life, mainly due to cardiopulmonary and neurologic causes. The major causes of death in infants after 1 week of age were infection and gastrointestinal disease. Among the surviving infants, 79% had moderate to severe bronchopulmonary dysplasia, 21% underwent surgical ligation of patent ductus arteriosus, 12% had severe intraventricular hemorrhage (grade III–IV), 38% had sepsis, 9% had necrotizing enterocolitis (stage ≥ 2), and 47% underwent laser treatment for retinopathy of prematurity. The median length of hospital stay was 132 days (range, 69–291), and 53% required assistive devices at discharge. CONCLUSION: Despite recent advances in neonatal intensive care, the survival and morbidity rates of infants with BW < 500 g need further improvement.
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spelling pubmed-83527872021-08-12 Survival and Morbidities in Infants with Birth Weight Less than 500 g: a Nationwide Cohort Study Hwang, Ji Hye Jung, Euiseok Lee, Byong Sop Kim, Ellen Ai-Rhan Kim, Ki-Soo J Korean Med Sci Original Article BACKGROUND: This study aimed to investigate the survival and morbidities of infants in the Korean Neonatal Network (KNN) with birth weight (BW) < 500 g. METHODS: The demographic and clinical data of 208 live-born infants with a BW < 500 g at a gestational age of ≥ 22 weeks who were treated in the neonatal intensive care units of the KNN between 2013 and 2017 were reviewed. RESULTS: The survival rate of the infants was 28%, with a median gestational age and BW of 24(3/7) weeks (range, 22(0/7)–33(6/7)) and 440 g (range, 220–499), respectively. Multivariable Cox proportional hazards analysis demonstrated that survival to discharge was associated with longer gestation, higher BW, female sex, singleton gestation, use of any antenatal corticosteroids, and higher Apgar scores at 5 minutes. The overall survival rates were significantly different between the BW categories of < 400 g and 400–499 g. However, there was no significant difference in the incidence of any morbidity between the BW groups. Half of the deaths of infants with BW < 500 g occurred within a week of life, mainly due to cardiopulmonary and neurologic causes. The major causes of death in infants after 1 week of age were infection and gastrointestinal disease. Among the surviving infants, 79% had moderate to severe bronchopulmonary dysplasia, 21% underwent surgical ligation of patent ductus arteriosus, 12% had severe intraventricular hemorrhage (grade III–IV), 38% had sepsis, 9% had necrotizing enterocolitis (stage ≥ 2), and 47% underwent laser treatment for retinopathy of prematurity. The median length of hospital stay was 132 days (range, 69–291), and 53% required assistive devices at discharge. CONCLUSION: Despite recent advances in neonatal intensive care, the survival and morbidity rates of infants with BW < 500 g need further improvement. The Korean Academy of Medical Sciences 2021-07-13 /pmc/articles/PMC8352787/ /pubmed/34402234 http://dx.doi.org/10.3346/jkms.2021.36.e206 Text en © 2021 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hwang, Ji Hye
Jung, Euiseok
Lee, Byong Sop
Kim, Ellen Ai-Rhan
Kim, Ki-Soo
Survival and Morbidities in Infants with Birth Weight Less than 500 g: a Nationwide Cohort Study
title Survival and Morbidities in Infants with Birth Weight Less than 500 g: a Nationwide Cohort Study
title_full Survival and Morbidities in Infants with Birth Weight Less than 500 g: a Nationwide Cohort Study
title_fullStr Survival and Morbidities in Infants with Birth Weight Less than 500 g: a Nationwide Cohort Study
title_full_unstemmed Survival and Morbidities in Infants with Birth Weight Less than 500 g: a Nationwide Cohort Study
title_short Survival and Morbidities in Infants with Birth Weight Less than 500 g: a Nationwide Cohort Study
title_sort survival and morbidities in infants with birth weight less than 500 g: a nationwide cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352787/
https://www.ncbi.nlm.nih.gov/pubmed/34402234
http://dx.doi.org/10.3346/jkms.2021.36.e206
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