Survival and outcome of very low birth weight infants born in a university hospital with level II NICU.

OBJECTIVES: Determine the survivals, neonatal outcomes to hospital discharge, and perinatal risks of death among VLBW infants born in the Thammasat University Hospital.

MATERIAL AND METHOD: This was a retrospective longitudinal study. Data were colleted from medical charts of all neonates with a gestational age of more than 25 weeks and birth weight of less than 1500 grams, who were born in Thammasat University Hospital for a 3-year period between July 1st, 2003 and June 30th, 2006. Antenatal history, perinatal data, and neonatal outcome until hospital discharge were extracted and analyzed.

RESULTS: Seventy-eight neonates with a birth weight between 600-1485 grams were analyzed. Survival rate of very-low-birth-weight (VLBW) infants and extremely-low-birth-weight (ELBW) infants were 81% and 52% respectively. Respiratory distress syndrome (RDS) was the major cause of death. Major morbidity was found in 35% of survived infants to hospital discharge. Unfavorable outcome was documented in infants with a birth weight < 750 grams. Perinatal risks of mortality among VLBW infants included no use of antenatal steroids (p = 0.015), gestational age of <28 weeks (p = 0.012), ELBW (p < 0.001), congenital abnormalities (p = 0.002), Apgar score at 5 minute <5 (p = 0.019), needed endotracheal intubation in the delivery room (p < 0.001), and first temperature at NICU < 35.0 degrees C (p = 0.023).

CONCLUSION: Overall survival and outcome among very-low-birth-weight infants born in Thammasat University Hospital is acceptable. The mortality and morbidity in extremely-low-birth-weight infants remained high. A continuing audit of these measures should be encouraged.