Morbidity and mortality trends in very–very low birth weight premature infants in light of recent changes in obstetric care

Péter Varga, Botond Berecz, Ákos Gasparics, Zsófia Dombi, Zsuzsa Varga, Judit Jeager, Zsófia Magyar, J. Rigó, József Gábor Joó, László Kornya

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective In this study, we describe trends in morbidity and mortality of preterm infants with less than 500 mg birth weight in the changing landscape of obstetric and neonatal care. Study design During a ten year study period between 2006 and 2016 we assessed outcome data for all neonates with less than 500 mg birth weight born at our Neonatal Intensive Care Unit. We divided study subjects into two groups based on whether their birth date fell in the first half (2006–2010; n = 39) versus the second half (2011–2015; n = 27) of the study period comparing clinical outcomes in the two groups. We also assessed several clinical parameters for association with postnatal survival by comparing relative frequencies for each clinical parameter among surviving infants versus mortality cases. Results Survival rate for preterm neonates with less than 500 mg birth weight born between 2006 and 2010 was 30.8%. This survival rate rose to 70.4% in the second half of the study period between 2011 and 2015 (p < 0.05). Among surviving babies premature birth was found to be predominantly associated with maternal hypertension or intrauterine growth restriction while in those who died premature birth due to premature rupture of membranes and spontaneous preterm labor were significantly more common. All surviving infants with less than 500 mg birth weight were born via cesarean section whereas among those who died cesarean section had been performed in only 80% and vaginal delivery in 20% representing a significant difference between the groups (p < 0.05). The majority (90.3%) of surviving infants with less than 500 mg birth weight had received surfactant therapy while the proportion of neonates receiving surfactant therapy among mortality cases was significantly lower (65.2%; p < 0.05). Discussion Our findings suggest that among premature neonates with less than 500 mg birth weight preterm delivery due to premature rupture of membranes and intrauterine infections represents the worse mortality risk. Steroid prophylaxis and measures to prevent and treat intrauterine infections with appropriate use of antibiotics can markedly improve survival in these cases. In premature neonates with less than 500 mg birth weight survival is more favorable after cesarean section compared to vaginal delivery.

Original languageEnglish
Pages (from-to)134-139
Number of pages6
JournalEuropean Journal of Obstetrics Gynecology and Reproductive Biology
Volume211
DOIs
Publication statusPublished - Apr 1 2017

Fingerprint

Low Birth Weight Infant
Birth Weight
Premature Infants
Obstetrics
Morbidity
Mortality
Newborn Infant
Cesarean Section
Premature Birth
Surface-Active Agents
Survival Rate
Spontaneous Rupture
Membranes
Premature Obstetric Labor
Neonatal Intensive Care Units
Infant Mortality
Infection
Rupture
Steroids
Mothers

Keywords

  • 500 mg birth weight
  • Antiobiotics treatment
  • Corticosteroid prophylaxis
  • Prematurity
  • Preterm birth
  • Survival

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this

Morbidity and mortality trends in very–very low birth weight premature infants in light of recent changes in obstetric care. / Varga, Péter; Berecz, Botond; Gasparics, Ákos; Dombi, Zsófia; Varga, Zsuzsa; Jeager, Judit; Magyar, Zsófia; Rigó, J.; Joó, József Gábor; Kornya, László.

In: European Journal of Obstetrics Gynecology and Reproductive Biology, Vol. 211, 01.04.2017, p. 134-139.

Research output: Contribution to journalArticle

Varga, Péter ; Berecz, Botond ; Gasparics, Ákos ; Dombi, Zsófia ; Varga, Zsuzsa ; Jeager, Judit ; Magyar, Zsófia ; Rigó, J. ; Joó, József Gábor ; Kornya, László. / Morbidity and mortality trends in very–very low birth weight premature infants in light of recent changes in obstetric care. In: European Journal of Obstetrics Gynecology and Reproductive Biology. 2017 ; Vol. 211. pp. 134-139.
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abstract = "Objective In this study, we describe trends in morbidity and mortality of preterm infants with less than 500 mg birth weight in the changing landscape of obstetric and neonatal care. Study design During a ten year study period between 2006 and 2016 we assessed outcome data for all neonates with less than 500 mg birth weight born at our Neonatal Intensive Care Unit. We divided study subjects into two groups based on whether their birth date fell in the first half (2006–2010; n = 39) versus the second half (2011–2015; n = 27) of the study period comparing clinical outcomes in the two groups. We also assessed several clinical parameters for association with postnatal survival by comparing relative frequencies for each clinical parameter among surviving infants versus mortality cases. Results Survival rate for preterm neonates with less than 500 mg birth weight born between 2006 and 2010 was 30.8{\%}. This survival rate rose to 70.4{\%} in the second half of the study period between 2011 and 2015 (p < 0.05). Among surviving babies premature birth was found to be predominantly associated with maternal hypertension or intrauterine growth restriction while in those who died premature birth due to premature rupture of membranes and spontaneous preterm labor were significantly more common. All surviving infants with less than 500 mg birth weight were born via cesarean section whereas among those who died cesarean section had been performed in only 80{\%} and vaginal delivery in 20{\%} representing a significant difference between the groups (p < 0.05). The majority (90.3{\%}) of surviving infants with less than 500 mg birth weight had received surfactant therapy while the proportion of neonates receiving surfactant therapy among mortality cases was significantly lower (65.2{\%}; p < 0.05). Discussion Our findings suggest that among premature neonates with less than 500 mg birth weight preterm delivery due to premature rupture of membranes and intrauterine infections represents the worse mortality risk. Steroid prophylaxis and measures to prevent and treat intrauterine infections with appropriate use of antibiotics can markedly improve survival in these cases. In premature neonates with less than 500 mg birth weight survival is more favorable after cesarean section compared to vaginal delivery.",
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AU - Varga, Zsuzsa

AU - Jeager, Judit

AU - Magyar, Zsófia

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N2 - Objective In this study, we describe trends in morbidity and mortality of preterm infants with less than 500 mg birth weight in the changing landscape of obstetric and neonatal care. Study design During a ten year study period between 2006 and 2016 we assessed outcome data for all neonates with less than 500 mg birth weight born at our Neonatal Intensive Care Unit. We divided study subjects into two groups based on whether their birth date fell in the first half (2006–2010; n = 39) versus the second half (2011–2015; n = 27) of the study period comparing clinical outcomes in the two groups. We also assessed several clinical parameters for association with postnatal survival by comparing relative frequencies for each clinical parameter among surviving infants versus mortality cases. Results Survival rate for preterm neonates with less than 500 mg birth weight born between 2006 and 2010 was 30.8%. This survival rate rose to 70.4% in the second half of the study period between 2011 and 2015 (p < 0.05). Among surviving babies premature birth was found to be predominantly associated with maternal hypertension or intrauterine growth restriction while in those who died premature birth due to premature rupture of membranes and spontaneous preterm labor were significantly more common. All surviving infants with less than 500 mg birth weight were born via cesarean section whereas among those who died cesarean section had been performed in only 80% and vaginal delivery in 20% representing a significant difference between the groups (p < 0.05). The majority (90.3%) of surviving infants with less than 500 mg birth weight had received surfactant therapy while the proportion of neonates receiving surfactant therapy among mortality cases was significantly lower (65.2%; p < 0.05). Discussion Our findings suggest that among premature neonates with less than 500 mg birth weight preterm delivery due to premature rupture of membranes and intrauterine infections represents the worse mortality risk. Steroid prophylaxis and measures to prevent and treat intrauterine infections with appropriate use of antibiotics can markedly improve survival in these cases. In premature neonates with less than 500 mg birth weight survival is more favorable after cesarean section compared to vaginal delivery.

AB - Objective In this study, we describe trends in morbidity and mortality of preterm infants with less than 500 mg birth weight in the changing landscape of obstetric and neonatal care. Study design During a ten year study period between 2006 and 2016 we assessed outcome data for all neonates with less than 500 mg birth weight born at our Neonatal Intensive Care Unit. We divided study subjects into two groups based on whether their birth date fell in the first half (2006–2010; n = 39) versus the second half (2011–2015; n = 27) of the study period comparing clinical outcomes in the two groups. We also assessed several clinical parameters for association with postnatal survival by comparing relative frequencies for each clinical parameter among surviving infants versus mortality cases. Results Survival rate for preterm neonates with less than 500 mg birth weight born between 2006 and 2010 was 30.8%. This survival rate rose to 70.4% in the second half of the study period between 2011 and 2015 (p < 0.05). Among surviving babies premature birth was found to be predominantly associated with maternal hypertension or intrauterine growth restriction while in those who died premature birth due to premature rupture of membranes and spontaneous preterm labor were significantly more common. All surviving infants with less than 500 mg birth weight were born via cesarean section whereas among those who died cesarean section had been performed in only 80% and vaginal delivery in 20% representing a significant difference between the groups (p < 0.05). The majority (90.3%) of surviving infants with less than 500 mg birth weight had received surfactant therapy while the proportion of neonates receiving surfactant therapy among mortality cases was significantly lower (65.2%; p < 0.05). Discussion Our findings suggest that among premature neonates with less than 500 mg birth weight preterm delivery due to premature rupture of membranes and intrauterine infections represents the worse mortality risk. Steroid prophylaxis and measures to prevent and treat intrauterine infections with appropriate use of antibiotics can markedly improve survival in these cases. In premature neonates with less than 500 mg birth weight survival is more favorable after cesarean section compared to vaginal delivery.

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