Hospital survival of very-low-birth-weight neonates from 1977 to 2000.
OBJECTIVE
To determine patterns of survival for very low birth weight (VLBW, birth weight 501 to 1500 g) neonates over 23 years.


METHODS
Data for 4873 VLBW neonates born from 1977 to 2000 were divided into five epochs. The primary outcome was survival to hospital discharge. Birth weight-specific survival rates were estimated by race and gender for each epoch. Presence of comorbidities and congenital anomalies, delivery mode, and provision of artificial ventilation were investigated to determine whether they could explain observed survival patterns.


RESULTS
From 1977 to 1995, survival increased from 50.2% to 81.0% as the proportion of VLBW neonates receiving artificial ventilation rose from 59.0% to 80.9%. Survival was unchanged between 1990 to 1995 and 1996 to 2000. Black females maintained a survival advantage over the entire study period. Survival improved for neonates with congenital anomalies over time, but had little impact on race/gender survival patterns. Survival patterns also could not be explained by comorbidity status, delivery mode, or access to artificial ventilation.


CONCLUSIONS
The survival advantage of VLBW black females persists and remains unexplained.
Kaiser
Jeffrey R
JR
Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, 800 Marshall Street, Little Rock, AR 72202-3591, USA.
Tilford
John M
JM
Simpson
Pippa M
PM
Salhab
Walid A
WA
Rosenfeld
Charles R
CR
D000013:Congenital Abnormalities / Q000401:mortality; D036861:Delivery, Obstetric / Q000379:methods; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality; D019102:Infant, Very Low Birth Weight; D008297:Male; D012121:Respiration, Artificial; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology