title: Death or survival with major morbidity in VLBW infants born at Brazilian neonatal research network centers.
abstract: OBJECTIVE
  To analyze unfavorable outcomes at hospital discharge of preterm infants born at Brazilian public university centers.
  
  
  METHODS
  Prospective cohort of 2646 inborn infants with gestational age 23-33 weeks and birth weight 400-1499 g, without malformations, born at 20 centers in 2012-2013. Unfavorable outcome was defined as in-hospital death or survival at hospital discharge with ≥1 major morbidities: bronchopulmonary dysplasia (BPD) at 36 corrected weeks, intraventricular hemorrhage (IVH) grades 3-4, periventricular leukomalacia (PVL) or surgically treated retinopathy of prematurity (ROP).
  
  
  RESULTS
  Among 2646 infants, 1390 (53%) either died or survived with major morbidities: 793 (30%) died; 497 (19%) had BPD; 358 (13%) had IVH 3-4 or PVL; and 84 (3%) had ROP. Logistic regression adjusted by center showed association of unfavorable outcome with: antenatal steroids (OR 0.70; 95%CI 0.55-0.88), C-section (0.72; 0.58-0.90), gestational age <30 (4.00; 3.16-5.07), being male (1.44; 1.19-1.75), small for gestational age (2.19; 1.72-2.78), 5th-min Apgar <7 (3.89; 2.88-5.26), temperature at NICU admission <36.0 °C (1.42; 1.15-1.76), respiratory distress syndrome (3.87; 2.99-5.01), proven late sepsis (1.33; 1.05-1.69), necrotizing enterocolitis (3.10; 2.09-4.60) and patent ductus arteriosus (1.69; 1.37-2.09).
  
  
  CONCLUSIONS
  More than half of the VLBW infants born at public university level 3 Brazilian hospitals either die or survive with major morbidities.
authors: a Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo , SP , Brazil .
authors: Ruth
authors: R
authors: Guinsburg
authors: a Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo , SP , Brazil .
authors: Maria Fernanda Branco
authors: MF
authors: de Almeida
authors: a Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo , SP , Brazil .
authors: Junia Sampel
authors: JS
authors: de Castro
authors: b Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil .
authors: Rita C
authors: RC
authors: Silveira
authors: c Hospital da Mulher Prof. José Aristodemo Pinotti, Centro de Atenção Integral à Saúde da Mulher, Universidade Estadual de Campinas , Campinas, São Paulo, , SP , Brazil .
authors: Jamil Pedro de Siqueira
authors: JP
authors: Caldas
authors: d Department of Pediatrics , Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil .
authors: Humberto Holmer
authors: HH
authors: Fiori
authors: e Hospital Universitário da Universidade Federal do Maranhão , São Luís , MA , Brazil .
authors: Marynéa Silva
authors: MS
authors: do Vale
authors: f Hospital de Clínicas, Faculdade de Medicina, Universidade Federal de Uberlândia , Uberlândia , MG , Brazil .
authors: Vânia Olivetti Steffen
authors: VO
authors: Abdallah
authors: g Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo , São Paulo , SP , Brazil .
authors: Laura Emilia Monteiro Bigélli
authors: LE
authors: Cardoso
authors: h Faculdade de Ciências Médicas de Minas Gerais , Belo Horizonte , MG , Brazil .
authors: Navantino
authors: N
authors: Alves Filho
authors: i Instituto Fernandes Figueira da Fundação Instituto Oswaldo Cruz , Rio de Janeiro , RJ , Brazil .
authors: Maria Elisabeth
authors: ME
authors: Moreira
authors: j Hospital Geral de Pirajussara , São Paulo , SP , Brazil .
authors: Ana Lucia
authors: AL
authors: Acquesta
authors: k Hospital Universitário da Universidade Estadual de Londrina , Londrina , PR , Brazil .
authors: Lígia S Lopes
authors: LS
authors: Ferrari
authors: l Faculdade de Medicina de Botucatu , Universidade Estadual Paulista , Botucatu , SP , Brazil .
authors: Maria Regina
authors: MR
authors: Bentlin
authors: m Department of Pediatrics , Universidade Federal do Paraná , Curitiba , PR , Brazil .
authors: Paulyne Stadler
authors: PS
authors: Venzon
authors: n Faculdade de Medicina de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto, São Paulo , SP , Brazil .
authors: Walusa Assad
authors: WA
authors: Gonçalves Ferri
authors: o Instituto de Medicina Integral Prof Fernando Figueira , Recife , PE , Brazil .
authors: Jucille do Amaral
authors: Jdo A
authors: Meneses
authors: p Hospital Universitário da Faculdade de Medicina, Universidade de São Paulo , São Paulo , SP , Brazil .
authors: Edna Maria De Albuquerque
authors: EM
authors: Diniz
authors: q Hospital Estadual Sumaré , Sumaré , SP , Brazil .
authors: Dulce Maria Toledo
authors: DM
authors: Zanardi
authors: r Hospital Estadual de Diadema , Diadema, São Paulo , SP , Brazil .
authors: Cristina Nunes
authors: CN
authors: Dos Santos
authors: s Universidade Estadual do Rio de Janeiro , Rio de Janeiro , RJ , Brazil , and.
authors: José Luiz
authors: JL
authors: Bandeira Duarte
authors: t Hospital das Clínicas, Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil.
authors: Maria Albertina Santiago
authors: MA
authors: Rego
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D001938:Brazil; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D011446:Prospective Studies
keywords: Bronchopulmonary dysplasia; intraventricular hemorrhage; neonatal mortality; periventricular leukomalacia; preterm newborn infant; retinopathy of prematurity; very low birth weight newborn infant