Short-term outcome in infants with a birthweight less than 501 grams.
OBJECTIVE
To report survival and morbidity until discharge in preterm infants <501 g with life support started immediately after birth.


METHODS
Cohort study of all preterm infants with birthweights < 501 g born in three tertiary perinatal centres between 1 January 1998 and 31 December 2001 (gestational age (GA) 25.2 [21.0-30.7] wk; birthweight 435 [290-500] g; median [range]).


RESULTS
A total of 107 infants with birthweights <501 g were born. Twenty-nine were stillborn. A prenatal decision to initiate life support immediately after birth was reached in 9/37 (24%) infants <24.0 wk GA and in 39/42 (93%) infants > or =24.0 wk GA. Survival was 3/37 (8%) and 26/41 (63%) in infants <24 wk GA and > or =24.0 wk GA, respectively. Twenty-nine of the 48 infants with immediate life support (60%) survived (95% CI: 46-75%). Forty-two of these 48 (88%) infants were small for gestational age. No infant without immediate life support survived (0/30). Twenty-three (79%) survivors developed chronic lung disease (CLD) and eight (28%) received photocoagulation for retinopathy of prematurity (ROP).


CONCLUSIONS
In this population of extremely low birthweight infants, survival was higher than in previous studies when life support was provided immediately after birth. Short-term morbidity was similar to other studies. The presented data on survival support our concept to offer immediate life support after birth in preterm infants with birthweights <501 g. The long-term outcome of these infants needs to be assessed urgently.
Department of Obstetrics and Gynaecology, Division of Neonatology, KIinikum Grosshadern, University of Munich, Munich, Germany. esther.fackeldey@helios.med.uni-muenchen.de
E
E
Rieger-Fackeldey
A
A
Schulze
F
F
Pohlandt
R
R
Schwarze
J
J
Dinger
W
W
Lindner
D015331:Cohort Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development; D019102:Infant, Very Low Birth Weight / Q000254:growth & development; D007363:Intensive Care Units, Neonatal; D008020:Life Support Care; D008297:Male; D009017:Morbidity; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome