title: Predictors of mortality and major morbidities in extremely low birth weight neonates.
abstract: OBJECTIVE
  To determine predictors of mortality and morbidity in extremely low birth weight neonates (ELBW) from a developing country.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Level III neonatal unit in Northern India.
  
  
  METHODS
  Neonates <1000 g born and admitted to intensive care during study period were enrolled. They were analyzed based on survival and development of major morbidity. Multivariable logistic regression model was used to determine independent risk factors.
  
  
  RESULTS
  Mortality and major morbidity (one or more of the following: Bronchopulmonary dysplasia (BPD), Retinopathy of Prematurity (ROP) requiring laser, grade III or IV intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) and necrotizing enterocolitis (NEC) stage III) during hospital stay.
  
  
  RESULTS
  Of 255 ELBW neonates born, 149 received optimal care, of which 78 (52%) survived and 57 (39%) developed morbidities. Mean birth weight and gestational age were 29.1±2.6 weeks and 843±108 g. Major causes of mortality were sepsis (46%), birth asphyxia (20%) and pulmonary hemorrhage (19%). Birth weight <800 g [OR (95% CI)-3.51 (1.39-8.89), P=0.008], mechanical ventilation [4.10 (1.64-10.28), P=0.003] and hypotensive shock [10.75 (4.00-28.89), P<0.001] predicted mortality while birth weight <800 g [3.75 (1.47-9.50), P=0.006], lack of antenatal steroids [2.62 (1.00-6.69), P=0.048), asphyxia [4.11 (1.45-11.69), P=0.008], ventilation [4.38 (1.29-14.79), P=0.017] and duration of oxygen therapy [0.004 (1.001-1.006), P=0.002] were the predictors of major morbidities.
  
  
  CONCLUSIONS
  Low birth weight, mechanical ventilation and hypotensive shock predicted mortality in ELBW neonates while low birth weight, lack of antenatal steroids, birth asphyxia, ventilation and duration of oxygen therapy were predictors for major morbidity.
authors.affiliation: Neonatal Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Correspondence to: Dr Kanya Mukhopadhyay, Additional Professor (Neonatology), Department of Pediatrics, PGIMER, Chandigarh, India. kanyapupul@yahoo.com.
authors.forename: Kanya
authors.initials: K
authors.lastname: Mukhopadhyay
authors.forename: Deepak
authors.initials: D
authors.lastname: Louis
authors.forename: Rama
authors.initials: R
authors.lastname: Mahajan
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
mesh_terms: D006801:Humans; D007194:India / Q000453:epidemiology; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D015233:Models, Statistical; D009017:Morbidity; D011446:Prospective Studies