title: Birth weight independently affects morbidity and mortality of extremely preterm neonates.
abstract: BACKGROUND
  Neonates born between 24 + 0 and 27 + 6 gestational weeks, widely known as extremely preterm neonates, present a category characterized by increased neonatal mortality and morbidity. Main objective of the present study is to analyze the effect of various epidemiological and pregnancy-related parameters on unfavorable neonatal mortality and morbidity outcomes.
  
  
  METHODS
  A retrospective study was performed enrolling cases delivered during 2003 - 2008 in our department. Cases of neonatal death as well as pathological Apgar score (≤ 4 in the first and ≤ 7 in the fifth minute of life), need for emergency resuscitation, respiratory disease syndrome (RDS), neonatal asphyxia, intraventricular hemorrhage (IVH) and neonatal death were recorded for neonates of our analysis. A multivariate regression model was used to correlate these outcomes with gestational week at delivery, maternal age, parity, kind of gestation (singleton or multiple), intrauterine growth restriction (IUGR), birth weight (BW), preterm premature rupture of membranes (PPROM), mode of delivery (vaginal delivery or cesarean section) and antenatal use of corticosteroids.
  
  
  RESULTS
  Out of 5,070 pregnancies delivered, 57 extremely preterm neonates were born (1.1%). Mean BW was 780.35 ± 176.0, RDS was observed in 93.0% (n = 53), resuscitation was needed in 54.4% (n = 31) while overall mortality rate was 52.6% (n = 30). BW was independently associated with neonatal death (P = 0.004), pathological Apgar score in the first (P = 0.05) and fifth minute of life (P = 0.04) as well as neonatal sepsis (P = 0.05).
  
  
  CONCLUSIONS
  BW at delivery is independently affecting neonatal mortality and morbidity parameters in extremely preterm neonates.
authors.affiliation: 3rd Academic Department Obstetrics & Gynaecology, Aristotle University of Thessaloniki, Medical School, "Hippokration" General Hospital, Thessaloniki, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Mamopoulos
authors.affiliation: 3rd Academic Department Obstetrics & Gynaecology, Aristotle University of Thessaloniki, Medical School, "Hippokration" General Hospital, Thessaloniki, Greece.
authors.forename: Stamatios
authors.initials: S
authors.lastname: Petousis
authors.affiliation: 3rd Academic Department Obstetrics & Gynaecology, Aristotle University of Thessaloniki, Medical School, "Hippokration" General Hospital, Thessaloniki, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Tsimpanakos
authors.affiliation: 3rd Academic Department Obstetrics & Gynaecology, Aristotle University of Thessaloniki, Medical School, "Hippokration" General Hospital, Thessaloniki, Greece.
authors.forename: Sophia
authors.initials: S
authors.lastname: Masouridou
authors.affiliation: Neonatal Intensive Care Unit, "Hippokration" General Hospital, Thessaloniki, Greece.
authors.forename: Kelly
authors.initials: K
authors.lastname: Kountourelli
authors.affiliation: 3rd Academic Department Obstetrics & Gynaecology, Aristotle University of Thessaloniki, Medical School, "Hippokration" General Hospital, Thessaloniki, Greece.
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Margioula-Siarkou
authors.affiliation: Neonatal Intensive Care Unit, "Hippokration" General Hospital, Thessaloniki, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Papouli
authors.affiliation: 3rd Academic Department Obstetrics & Gynaecology, Aristotle University of Thessaloniki, Medical School, "Hippokration" General Hospital, Thessaloniki, Greece.
authors.forename: David
authors.initials: D
authors.lastname: Rousso
keywords: Birth weight; Extremely preterm; Gestational age; Neonatal morbidity; Neonatal mortality