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.
Hodgman
J E
JE
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.
Barton
L
L
Pavlova
Z
Z
Fassett
M J
MJ
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