title: [Mortality of very low birth weight infants during a 24 year period in Hesse a province of Germany - impact of variation in registration].
abstract: OBJECTIVE
  To study mortality in very low birth weight infants (VLBW) and the impact variation how to register that.
  
  
  METHODS
  Data from the Hessian neonatal register from a 24 years period were analyzed. The only outcome criterion was mortality. The whole study time was divided into 6 parts for a period of 4 years. The death rate of preterm infants of 24 weeks of gestation, of those below 24 weeks, and of preterms of 27 weeks was analyzed separately.
  
  
  RESULTS
  During 24 years the absolute number of deaths in the group of VLBW increased from an average of 37 patients per year to 60 (p>0.05). The relative mortality decreased from 13.5% to 10.1%. There was an increasing registration of extreme preterm babies of 24 weeks or less. In the last period 13.3% of all VLBW were <25 weeks. These patients represented 54.7% of all deaths in VLBW during 2009-2012. Mortality of preterms of 24 weeks of gestation decreased significantly from 83.3% at the start of the registry to 20.8% in the last period (p=0.007) whereas death rate of preterm infants of 27 weeks dropped from 24.4% to 13.6% (p>0.05). There were also more admissions of extreme preterm infants to neonatal intensive care units.
  
  
  CONCLUSIONS
  Infant death rates are influenced by variation in registration of extreme preterm infants. On the other hand increased registration of these patients seems to encourage doctors to treat them.
authors.affiliation: Universitätslinik Frankfurt/Main, Neonatology, Frankfurt/Main.
authors.forename: R L
authors.initials: RL
authors.lastname: Schlößer
authors.affiliation: Klinikum Darmstadt, Südhessisches Perinatalzentrum, Darmstadt.
authors.forename: G
authors.initials: G
authors.lastname: Frey
authors.affiliation: Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Klinik für Kinder- und Jugendmedizin, Marburg.
authors.forename: M
authors.initials: M
authors.lastname: Zemlin
authors.affiliation: Geschäftsstelle Qualitätssicherung Hessen, GQH, Eschborn.
authors.forename: B
authors.initials: B
authors.lastname: Misselwitz
mesh_terms: D003644:Death Certificates; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality*; D019102:Infant, Very Low Birth Weight; D008297:Male; D012042:Registries / Q000706:statistics & numerical data*; D018570:Risk Assessment; D015996:Survival Rate