Postdischarge infant mortality among very low birth weight infants: a population-based study.
OBJECTIVE
The objective of this study was to identify factors that were associated with death after discharge from the NICU of very low birth weight infants in a population-based study.


METHODS
From a national cohort of 13,430 very low birth weight infants who were born in Israel from 1995 to 2003, 10,602 infants were discharged from the hospital and composed the study population. Demographic and clinical data regarding the pregnancy, delivery, and neonatal course were obtained from the Israel national very low birth weight infant database. Data on each case of death during the postdischarge period until 1 year of age were provided by the Ministry of Health from national linked birth and death certificates. Univariate analyses and a multivariable logistic regression analyses were performed to examine the perinatal and neonatal risk factors for postdischarge death.


RESULTS
The postdischarge mortality rate was 7.5 per 1000 (80 of 10,602 infants discharged from the hospital). The death rate was significantly higher in non-Jewish infants, infants who were born to young mothers, and infants who were born to low-educated mothers. After adjustment for demographic characteristics and perinatal and neonatal variables, postdischarge mortality was independently associated with congenital malformations, neonatal seizures, necrotizing enterocolitis, and bronchopulmonary dysplasia.


CONCLUSIONS
Although the postdischarge death rate was relatively low in our cohort of very low birth weight infants, attention should be focused on the subgroups of infants who are at higher risk to decrease their mortality further.
Kugelman
Amir
A
Department of Neonatology, Bnai Zion Medical Center, Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. dramir@netvision.net.il
Reichman
Brian
B
Chistyakov
Irena
I
Boyko
Valentina
V
Levitski
Orna
O
Lerner-Geva
Liat
L
Riskin
Arieh
A
Bader
David
D
D001997:Bronchopulmonary Dysplasia / Q000401:mortality; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000401:mortality; D019992:Databases as Topic; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007557:Israel / Q000453:epidemiology; D007585:Jews; D008297:Male; D008423:Maternal Age; D015999:Multivariate Analysis; D010351:Patient Discharge; D012307:Risk Factors; D012640:Seizures / Q000401:mortality