title: Outcomes of neonates with birth weight⩽500 g: a 20-year experience.
abstract: OBJECTIVE
  Ethical dilemmas continue regarding resuscitation versus comfort care in extremely preterm infants. Counseling parents and making decisions regarding the care of these neonates should be based on reliable, unbiased and representative data drawn from geographically defined populations. We reviewed survival and morbidity data for our population at the edge of viability.
  
  
  METHODS
  A retrospective review of our perinatal database was carried out to identify all infants born alive and admitted to the neonatal intensive care unit (NICU) with BW⩽500 g between 1989 and 2009. Data from the initial hospital stay and follow-up at 24 months were collected.
  
  
  RESULTS
  Out of 22 672 NICU admissions, 273 were eligible: 212 neonates were reviewed after excluding infants with comfort care. BW ranged from 285 to 500 g (mean 448 g) and gestational age range 22 to 28 weeks (median 24 week). Sixty-one (28.8%) survived until discharge. Only 13.8% males survived compared with 39.2% females (P<0.05). Half (49%) were discharged with home oxygen/monitor. Fifty (82%) patients' charts were available to review at the 24-month follow-up. Thirty-three percent of surviving infants had a normal neurodevelopmental assessment at 24 months. Forty-three percent had weight/head circumference<5th percentile at 24 months.
  
  
  CONCLUSIONS
  About a third of neonates admitted to NICU with ⩽500 g BW survived, with 33% of those surviving, demonstrating age-appropriate development at a 24-month follow-up visit.
authors.affiliation: Division of Neonatal Medicine, Department of Pediatrics and OB/GYN, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: K
authors.initials: K
authors.lastname: Upadhyay
authors.affiliation: Division of Neonatal Medicine, Department of Pediatrics and OB/GYN, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: M
authors.initials: M
authors.lastname: Pourcyrous
authors.affiliation: Division of Neonatal Medicine, Department of Pediatrics and OB/GYN, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: R
authors.initials: R
authors.lastname: Dhanireddy
authors.affiliation: Division of Neonatal Medicine, Department of Pediatrics and OB/GYN, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Talati
mesh_terms: D002657:Child Development; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D062071:Infant, Extremely Premature / Q000254:growth & development / Q000502:physiology; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development / Q000502:physiology; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology