Obstetric variables predicting survival of the immature newborn (less than or equal to 1000 gm): a five-year experience at a single perinatal center.
The immature neonate constitutes less than 3% of total births and yet accounts for almost 50% of all perinatal deaths. In a 5-year period, 476 consecutive live and inborn neonates weighing less than or equal to 1000 gm were studied. The purpose of this study was to describe our experience with these pregnancies and determine the obstetric predictors of survival. Statistical methods of univariate and multivariate analysis were used. Survival was defined as the discharge home of an alive infant. The overall survival rate without exclusions was 40.3%. The following variables were most significant and accurately predicted survivors in 76.2% and nonsurvivors in 69.2% of cases: a combination of birth weight, 5-minute Apgar score, gestational age, cervical dilatation on admission, sex, a more recent study time interval, and race. Of the factors studied, the following were directly related to advancing gestational age and birth weight: higher Apgar scores at 1 and 5 minutes, increased operative delivery rate, and increased frequency of tocolysis and glucocorticoid usage; of these factors, only the 5-minute Apgar score remained statistically significant, when controlling for gestational age and birth weight by multivariate analysis.
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D007363:Intensive Care Units, Neonatal; D010500:Perinatology; D011247:Pregnancy; D013223:Statistics as Topic; D014481:United States