Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study.
BACKGROUND
With the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW) survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU) stay in the mainland of China.


METHODS
All infants admitted to 26 NICUs with a birth weight (BW) < l000 g were included between January l, 2011 and December 31, 2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors.


RESULTS
A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age (GA) was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3%) died and another 69 infants (26.7%) died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019). BW < 750 g and GA < 28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization.


CONCLUSIONS
Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.
Hui-Jia
HJ
Lin
Department of Neonatal Intensive Care Unit, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310053, China.
Li-Zhong
LZ
Du
Xiao-Lu
XL
Ma
Li-Ping
LP
Shi
Jia-Hua
JH
Pan
Xiao-Mei
XM
Tong
Qiu-Ping
QP
Li
Jian-Guo
JG
Zhou
Bing
B
Yi
Ling
L
Liu
Yun-Bing
YB
Chen
Qiu-Fen
QF
Wei
Hui-Qing
HQ
Wu
Mei
M
Li
Cui-Qing
CQ
Liu
Xi-Rong
XR
Gao
Shi-Wen
SW
Xia
Wen-Bin
WB
Li
Chao-Ying
CY
Yan
Ling
L
He
Kun
K
Liang
Xiao-Yu
XY
Zhou
Shu-Ping
SP
Han
Qin
Q
Lyu
Yin-Ping
YP
Qiu
Wen
W
Li
Dong-Mei
DM
Chen
Hong-Ru
HR
Lu
Xiao-Hong
XH
Liu
Hong
H
Liu
Zhen-Lang
ZL
Lin
Li
L
Liu
Jia-Jun
JJ
Zhu
Hong
H
Xiong
Shao-Jie
SJ
Yue
Si-Qi
SQ
Zhuang
D002681:China; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D009017:Morbidity; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality; D012189:Retrospective Studies; D011795:Surveys and Questionnaires