OBJECTIVE: To describe and analyze outcomes in very-low-birth-weight (VLBW) infants treated in 11 Neonatal Intensive Care Units (NICUs) from four South American countries. This study is the first of a multination collaboration and can serve as a baseline for future quality and resource utilization efforts. STUDY DESIGN: Biodemographic data and multiple outcome measures were prospectively collected from October 1997 until August 1998. A logistic regression model was used to define risk factors in primary outcome measures, death, and bronchopulmonary dysplasia (BPD). Center differences were compared using chi-squared analysis. RESULTS: In 385 VLBW infants enrolled, mortality rate was 27%, with a range from 11% to 51% among NICUs. A lower BW, lower gestational age (GA), lack of antenatal steroids (AS), and air leaks (AL) were associated with increased risk of death. A lower BW, lower GA, AL, need for surfactant, necrotizing enterocolitis, and need for intubation were associated with increased risk of BPD. CONCLUSION: This study provides actual information about VLBW infants' prognosis in a SA region. Mortality rate variability among NICUs may be explained by differences in population and resources, but also by lack of implementation of proven beneficial therapies such as AS administration.
OBJECTIVE: To describe and analyze outcomes in very-low-birth-weight (VLBW) infants treated in 11 Neonatal Intensive Care Units (NICUs) from four South American countries. This study is the first of a multination collaboration and can serve as a baseline for future quality and resource utilization efforts. STUDY DESIGN: Biodemographic data and multiple outcome measures were prospectively collected from October 1997 until August 1998. A logistic regression model was used to define risk factors in primary outcome measures, death, and bronchopulmonary dysplasia (BPD). Center differences were compared using chi-squared analysis. RESULTS: In 385 VLBW infants enrolled, mortality rate was 27%, with a range from 11% to 51% among NICUs. A lower BW, lower gestational age (GA), lack of antenatal steroids (AS), and air leaks (AL) were associated with increased risk of death. A lower BW, lower GA, AL, need for surfactant, necrotizing enterocolitis, and need for intubation were associated with increased risk of BPD. CONCLUSION: This study provides actual information about VLBW infants' prognosis in a SA region. Mortality rate variability among NICUs may be explained by differences in population and resources, but also by lack of implementation of proven beneficial therapies such asAS administration.