Risk factors for post-neonatal intensive care unit discharge mortality among extremely low birth weight infants.
OBJECTIVE
The study goal was to evaluate maternal and neonatal risk factors associated with post-neonatal intensive care unit (NICU) discharge mortality among extremely low birth weight (ELBW) infants.


METHODS
This is a retrospective analysis of ELBW (<1000 g) and <27 weeks' gestational age infants born in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network sites between January 2000 and June 2007. Infants were tracked until death or 18 to 22 months' corrected age. Infants who died between NICU discharge and the 18- to 22-month follow-up visit were classified as post-NICU discharge mortality (P-NDM). Association of maternal and infant risk factors with P-NDM was determined using logistic regression analysis. A prediction model with 6 significant predictors was developed and validated.


RESULTS
There were 5364 infants who survived to NICU discharge; 557 (10%) infants were lost to follow-up, and 107 infants died following NICU discharge. P-NDM rate was 22.3 per 1000 ELBW infants. In the prediction model, African American race, unknown maternal health insurance, and hospital stay ≥ 120 days significantly increased risk, and maternal exposure to intrapartum antibiotics was associated with decreased risk of P-NDM.


CONCLUSIONS
We identified African American race, unknown medical insurance, and prolonged NICU stay as risk factors associated with P-NDM among ELBW infants.
Department of Pediatrics, Wayne State University, Detroit, MI, USA.
Lilia C
LC
De Jesus
Athina
A
Pappas
Seetha
S
Shankaran
Douglas
D
Kendrick
Abhik
A
Das
Rosemary D
RD
Higgins
Edward F
EF
Bell
Barbara J
BJ
Stoll
Abbot R
AR
Laptook
Michele C
MC
Walsh
D015331:Cohort Studies; D005260:Female; D006801:Humans; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D010351:Patient Discharge; D012189:Retrospective Studies; D012307:Risk Factors