title: Changes in perinatal care and predictors of in-hospital mortality for very low birth weight preterm infants.
abstract: OBJECTIVE
  Mortality of very low birth weight premature infants is of great public health concern. To better guide local intervention program, it is essential that current and reliable statistics be collected to understand the factors associated with mortality of these infants.
  
  
  METHODS
  Data of very low birth weight premature infants admitted to a neonatal unit during 2002-2009 was retrospectively collected. Changes in perinatal care between two halves of the study period (2002-2005 and 2006-2009) were identified. Factors associated with in-hospital mortality were found by logistic regression and a predictive score model was established.
  
  
  RESULTS
  A total of 475 cases were enrolled. In-hospital mortality decreased from 29.8% in 2002-2005 to 28.1% in 2006-2009 (P>0.05). More infants born <28 gestational weeks survived to discharge in the latter epoch (38.1% vs 8.3%, P<0.05). Persistent pulmonary hypertension of newborn, pulmonary hemorrhage, birth weight <000 grams, gestational age <33 weeks, feeding before 3 postnatal days and enteral feeding were found predictors of in-hospital mortality by logistic regression. The discriminating ability of the predictive model was 82.4% and the cutoff point was -0.56.
  
  
  CONCLUSIONS
  Survival of very low birth weight premature neonates was not significantly improved in 2006-2009 than 2002-2005. Infants with a score higher than -0.56 were assessed to be at high risk of in-hospital mortality. Multi-center studies of planned follow-up are needed to develop a comprehensive and applicable score system.
authors: Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors: Ying
authors: Y
authors: Dong
authors: Guang
authors: G
authors: Yue
authors: Jia-Lin
authors: JL
authors: Yu
keywords: Mortality; Predictive Score Model; Premature Infant; Very Low Birth Weight
references: Pediatrics. 2005 Feb;115(2):396-405
references: 15689337
references: Indian J Pediatr. 2008 Mar;75(3):267-9
references: 18376096
references: Pediatrics. 2007 Jul;120(1):e1-9
references: 17606536
references: Singapore Med J. 2008 Jul;49(7):556-60
references: 18695864
references: Am J Nurs. 2005 Jul;105(7):56-64; quiz 65
references: 15995395
references: Cochrane Database Syst Rev. 2006 Jul 19;(3):CD004454
references: 16856047
references: S Afr Med J. 2005 Jul;95(7):504-9
references: 16156449
references: Cochrane Database Syst Rev. 2009 Jul 08;(3):CD000504
references: 19588318
references: J Pediatr. 2001 Jan;138(1):92-100
references: 11148519
references: Acta Paediatr Taiwan. 2000 Nov-Dec;41(6):308-12
references: 11198936
references: J Trop Pediatr. 2009 Aug;55(4):262-4
references: 19066170
references: Arch Dis Child Fetal Neonatal Ed. 2003 Jan;88(1):F23-8
references: 12496222
references: Early Hum Dev. 2000 Sep;59(3):175-91
references: 10996273
references: N Engl J Med. 2008 Apr 17;358(16):1700-11
references: 18420502
references: West Indian Med J. 2006 Jun;55(3):165-9
references: 17087100
references: Ann Radiol (Paris). 1974 Nov;17(7):669-83
references: 4460832
references: BMC Pediatr. 2010 May 06;10:30
references: 20444296
references: Nestle Nutr Workshop Ser Pediatr Program. 2007;59:193-204; discussion 204-8
references: 17245100
references: Neonatology. 2008;94(4):245-54
references: 18836284
references: Pediatrics. 2000 May;105(5):1051-7
references: 10790462
references: J Perinat Med. 2008;36(3):191-6
references: 18576926
references: Eur J Obstet Gynecol Reprod Biol. 2004 Feb 10;112(2):170-7
references: 14746953
references: World J Gastroenterol. 2008 Oct 28;14(40):6133-9
references: 18985802
references: Cochrane Database Syst Rev. 2008 Oct 08;(4):CD006764
references: 18843729
references: Arch Dis Child Fetal Neonatal Ed. 2004 Sep;89(5):F419-22
references: 15321961
references: Neonatology. 2010 Jun;97(4):402-17
references: 20551710
references: Am J Perinatol. 2010 May;27(5):367-73
references: 20013579