Survival, Short-Term, and Long-Term Morbidities of Neonates with Birth Weight < 500 g

Abstract

Objectives The objective of this study was to describe survival, short-term, and long-term morbidities of neonates with birth weight < 500 g.

Study Design Retrospective cohort studies to calculate survival, short-term, and long-term morbidity rates of neonates born weighing < 500 g from 1993 to 2012 and neurodevelopmental impairment rates at 4.5 years for births 1993 to 2008 in one center.

Results Of 549 inborn neonates with birth weight < 500 g, 4% survived. For live births and neonatal intensive care unit (NICU) admissions, 10 and 55% survived, respectively. Of 28 NICU (inborn and outborn) survivors (median birth weight 460 g and gestation 25.9 weeks [range: 22.6–30.3 weeks]), 71% were inborn, 50% male, and 75% were small for gestational age. One in five neonates was a twin or multiple. Short-term morbidities noted were bronchopulmonary dysplasia (91%), culture proven sepsis (50%), retinopathy of prematurity (41%), and severe brain injury (22%); 27% had no long-term impairment, 23% one, 23% two, 18% three, and 9% four impairments in motor, cognitive, vision, and/or hearing domains. At 4.5 years, 29% had visual impairment, 10% wore hearing aids, 50% had IQ < 70, 18% cerebral palsy, and 68% had low motor scores.

Conclusion Only 4% of births < 500 g survived. All survivors had short-term morbidities; 27% neonates survived without long-term major impairments.

Keywords

extremely low birth weight - neurodevelopmental outcome - survival - neonate

Authors' Contributions

R.A.B. conceptualized the study, coordinated and supervised the data extraction, drafted the initial article, and approved the final article as submitted. J.P.T. performed the data analysis and interpretation, reviewed and revised the article, and approved the final article as submitted. M.M., J.A., and P.H. helped in interpreting the data, reviewed the article, and approved the final article as submitted. R.E.G. critically reviewed the data interpretation, revised the article, and approved the final article as submitted. A.S. designed the study, supervised the study, critically reviewed and revised the article, and approved the final article as submitted.

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