Predictors of Mortality and Major Morbidities in Extremely Low Birth Weight Neonates.
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Date
2013-12
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Abstract
Objectives: To determine predictors of mortality and morbidity in
extremely low birth weight neonates (ELBW) from a developing
country
Study design: Prospective observational study.
Setting: Level III neonatal unit in Northern India.
Subjects: Neonates <1000g born and admitted to intensive care
during study period were enrolled. They were analyzed based on
survival and development of major morbidity. Multivariable logistic
regression model was used to determine independent risk
factors.
Outcome: Mortality and major morbidity (one or more of the
following: Bronchopulmonary dysplasia (BPD), Retinopathy of
Prematurity (ROP) requiring laser, grade III or IV intraventricular
hemorrhage (IVH), periventricular leukomalacia (PVL) and
necrotizing enterocolitis (NEC) stage III) during hospital stay.
Results: Of 255 ELBW neonates born, 149 received optimal care,
of which 78 (52%) survived and 57 (39%) developed morbidities.
Mean birth weight and gestational age were 29.1±2.6 weeks and
843±108g. Major causes of mortality were sepsis (46%), birth
asphyxia (20%) and pulmonary hemorrhage (19%). Birth weight
≤800g [OR (95% CI)-3.51 (1.39-8.89), P=0.008], mechanical
ventilation [4.10 (1.64-10.28), P=0.003] and hypotensive shock
[10.75 (4.00-28.89), P<0.001] predicted mortality while birth weight
≤800g [3.75 (1.47-9.50), P=0.006], lack of antenatal steroids [2.62
(1.00-6.69), P=0.048), asphyxia [4.11 (1.45-11.69), P=0.008],
ventilation [4.38 (1.29-14.79), P=0.017] and duration of oxygen
therapy [0.004 (1.001-1.006), P=0.002] were the predictors of major
morbidities.
Conclusions: Low birth weight, mechanical ventilation and
hypotensive shock predicted mortality in ELBW neonates while
low birth weight, lack of antenatal steroids, birth asphyxia,
ventilation and duration of oxygen therapy were predictors for
major morbidity.
Description
Keywords
ELBW neonate, India, Mortality, Morbidity, Predictors, Survival
Citation
Mukhopadhyay Kanya, Louis Deepak, Mahajan Rama, Kumar Praveen. Predictors of Mortality and Major Morbidities in Extremely Low Birth Weight Neonates. Indian Pediatrics. 2013 December; 50(12): 1119-1123.