Infection as a cause of death in the extremely-low-birth-weight infant.
OBJECTIVE
To determine the causes of neonatal death for extremely-low-birth-weight (ELBW) infants.


METHODS
All liveborn infants below 1000 g birth weight born from 1994 to 1998 who died and were autopsied were included. Maternal and infant characteristics, placental histology, autopsy material and culture results were obtained.


RESULTS
A total of 263 ELBW infants were born alive, 104 (40%) died and 44 (42%) were autopsied. Placentas were available for 41 (93%). Infection was the leading cause of death in the autopsied babies (25/44; 57%). Sixteen (64%) of these deaths occurred within the first 48 h and were classified as being due to congenital infections. Twenty-two of 41 (54%) placentas showed evidence of infection. Infection as a cause of death peaked at 22 weeks. Other causes of death were lethal anomalies (20%), respiratory distress and its complications (9%) and immaturity, intraventricular hemorrhage and other conditions (14%).


CONCLUSIONS
Congenital infection is the leading cause of death in ELBW infants.
Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles County and University of Southern California Medical Center, Los Angeles, California, USA.
J E
JE
Hodgman
L
L
Barton
Z
Z
Pavlova
M J
MJ
Fassett
D001344:Autopsy; D002423:Cause of Death; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007239:Infections / Q000401:mortality*; D008423:Maternal Age; D012189:Retrospective Studies