Early predictors of mortality in very low birth weight neonates.
OBJECTIVE
To evaluate early predictors of mortality in very low birth weight neonates.


METHODS
Teaching hospital.


METHODS
Case control study.


METHODS
Hospital born very low birth weight newborns (500-1500 g) enrolled for study and followed up till death or 28 days. Infants' birth data and data on physiologic alterations, investigation and interventions in the first 24 hours of life and CRIB score were analyzed for their ability to predict neonatal mortality.


RESULTS
115 subjects were enrolled into the study of which 47 died in the neonatal period. The factors significantly associated with early neonatal mortality included birth weight, gestation, low Apgar scores, need for assisted ventilation at birth, need for supplemental oxygen and mechanical ventilation in the first 24 hours, presence of shock, hypoxia and acidosis (p < 0.05). The factors associated with late neonatal mortality were birth weight and gestation only. Multivariate analysis of these factors showed that besides low birth weight, shock, need for mechanical ventilation, acidosis and high alveolar-arterial oxygen gradients were significant predictors of neonatal mortality. When compared with the CRIB score, birth weight <1200g proved to be an equally good predictor of mortality risk.


CONCLUSIONS
VLBW neonates with disturbed cardio-pulmonary physiology during the first 24 hours of life, especially those in need of mechanical ventilation, are at an increased risk of early neonatal mortality.
Gera
T
T
Department of Pediatrics, Maulana Azad Medical College, New Delhi 110 002, India. medha@del3.vsnl.net.in
Ramji
S
S
D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D011237:Predictive Value of Tests; D013997:Time Factors