title: Fetal infants: the fate of 4172 infants with birth weights of 401 to 500 grams--the Vermont Oxford Network experience (1996-2000).
abstract: OBJECTIVE
  Improvement in the survival of extremely low birth weight infants requires that we evaluate the limits of our care and assess the impact of treatment on a population of infants who previously rarely survived.
  
  
  METHODS
  A review was conducted of demographic and clinical data of infants who had birth weight 401 to 500 g and were entered in the Vermont Oxford Network Database between 1996 and 2000.
  
  
  RESULTS
  A total of 4172 infants who weighed 401-500 g (mean gestational age: 23.3 +/- 2.1 weeks) were born at 346 participating centers. Overall, 17% survived until discharge. A total of 2186 (52%) died in the delivery room (DR), and 1986 (48%) were admitted to a neonatal intensive care unit (NICU). Compared with infants who died in the DR, infants who survived the DR and were admitted to the NICU were more likely to be female (58% vs 49%), to be small for gestational age (56% vs 11%), to have received prenatal steroids (61% vs 12%), and to have been delivered by cesarean section (55% vs 5%). Thirty-six percent of NICU admissions survived to discharge. Mean gestational age of the 690 NICU survivors was 25.3 +/- 2.0 weeks. These survivors experienced significant morbidity in the NICU.
  
  
  CONCLUSIONS
  An appreciable number of these marginally viable fetal infants survive. They experienced a high rate of serious morbidities while in the NICU. There is very little information about long-term outcomes, as the medical and developmental status of few of these infants has been followed carefully. Parents should be made aware of the high incidence of serious problems, and concerted efforts should be made to follow the status of these infants.
authors.affiliation: Department of Pediatrics, College of Medicine, University of Vermont, Burlington, Vermont 05405-0068, USA. jerold.lucey@uvm.edu
authors.forename: Jerold F
authors.initials: JF
authors.lastname: Lucey
authors.forename: Cherise A
authors.initials: CA
authors.lastname: Rowan
authors.forename: Patricia
authors.initials: P
authors.lastname: Shiono
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Wilkinson
authors.forename: Sarah
authors.initials: S
authors.lastname: Kilpatrick
authors.forename: Nathaniel R
authors.initials: NR
authors.lastname: Payne
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Horbar
authors.forename: Joseph
authors.initials: J
authors.lastname: Carpenter
authors.forename: Jeannette
authors.initials: J
authors.lastname: Rogowski
authors.forename: Roger F
authors.initials: RF
authors.lastname: Soll
mesh_terms: D016208:Databases, Factual; D005260:Female; D005865:Gestational Age; D017052:Hospital Mortality; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality* / Q000628:therapy; D019102:Infant, Very Low Birth Weight; D008297:Male; D015996:Survival Rate