Kanya Mukhopadhyay1, Deepak Louis, Rama Mahajan, Praveen Kumar. 1. Neonatal Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Correspondence to: Dr Kanya Mukhopadhyay, Additional Professor (Neonatology), Department of Pediatrics, PGIMER, Chandigarh, India. kanyapupul@yahoo.com.
Abstract
OBJECTIVE: To determine predictors of mortality and morbidity in extremely low birth weight neonates (ELBW) from a developing country. STUDY DESIGN: Prospective observational study. SETTING: Level III neonatal unit in Northern India. SUBJECTS: Neonates <1000 g born and admitted to intensive care during study period were enrolled. They were analyzed based on survival and development of major morbidity. Multivariable logistic regression model was used to determine independent risk factors. OUTCOME: Mortality and major morbidity (one or more of the following: Bronchopulmonary dysplasia (BPD), Retinopathy of Prematurity (ROP) requiring laser, grade III or IV intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) and necrotizing enterocolitis (NEC) stage III) during hospital stay. RESULTS: Of 255 ELBW neonates born, 149 received optimal care, of which 78 (52%) survived and 57 (39%) developed morbidities. Mean birth weight and gestational age were 29.1±2.6 weeks and 843±108 g. Major causes of mortality were sepsis (46%), birth asphyxia (20%) and pulmonary hemorrhage (19%). Birth weight <800 g [OR (95% CI)-3.51 (1.39-8.89), P=0.008], mechanical ventilation [4.10 (1.64-10.28), P=0.003] and hypotensive shock [10.75 (4.00-28.89), P<0.001] predicted mortality while birth weight <800 g [3.75 (1.47-9.50), P=0.006], lack of antenatal steroids [2.62 (1.00-6.69), P=0.048), asphyxia [4.11 (1.45-11.69), P=0.008], ventilation [4.38 (1.29-14.79), P=0.017] and duration of oxygen therapy [0.004 (1.001-1.006), P=0.002] were the predictors of major morbidities. CONCLUSIONS: Low birth weight, mechanical ventilation and hypotensive shock predicted mortality in ELBW neonates while low birth weight, lack of antenatal steroids, birth asphyxia, ventilation and duration of oxygen therapy were predictors for major morbidity.
OBJECTIVE: To determine predictors of mortality and morbidity in extremely low birth weight neonates (ELBW) from a developing country. STUDY DESIGN: Prospective observational study. SETTING: Level III neonatal unit in Northern India. SUBJECTS: Neonates <1000 g born and admitted to intensive care during study period were enrolled. They were analyzed based on survival and development of major morbidity. Multivariable logistic regression model was used to determine independent risk factors. OUTCOME: Mortality and major morbidity (one or more of the following: Bronchopulmonary dysplasia (BPD), Retinopathy of Prematurity (ROP) requiring laser, grade III or IV intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) and necrotizing enterocolitis (NEC) stage III) during hospital stay. RESULTS: Of 255 ELBW neonates born, 149 received optimal care, of which 78 (52%) survived and 57 (39%) developed morbidities. Mean birth weight and gestational age were 29.1±2.6 weeks and 843±108 g. Major causes of mortality were sepsis (46%), birth asphyxia (20%) and pulmonary hemorrhage (19%). Birth weight <800 g [OR (95% CI)-3.51 (1.39-8.89), P=0.008], mechanical ventilation [4.10 (1.64-10.28), P=0.003] and hypotensive shock [10.75 (4.00-28.89), P<0.001] predicted mortality while birth weight <800 g [3.75 (1.47-9.50), P=0.006], lack of antenatal steroids [2.62 (1.00-6.69), P=0.048), asphyxia [4.11 (1.45-11.69), P=0.008], ventilation [4.38 (1.29-14.79), P=0.017] and duration of oxygen therapy [0.004 (1.001-1.006), P=0.002] were the predictors of major morbidities. CONCLUSIONS: Low birth weight, mechanical ventilation and hypotensive shock predicted mortality in ELBW neonates while low birth weight, lack of antenatal steroids, birth asphyxia, ventilation and duration of oxygen therapy were predictors for major morbidity.
Authors: Khalid M Bhatti; Zainab N Al-Balushi; Mahmoud H Sherif; Sareyah M Al-Sibai; Ashfaq A Khan; Mazen A Mohammed; Maria F Batacalan; Cheryl C Montemayor; Mohammad Fazalullah; Masood Ahmed; Mathew Kripail; Asad Ur-Rahman; Zenaida Reyes; Mohamed Abdellatif Journal: Sultan Qaboos Univ Med J Date: 2015-01-21
Authors: Jichong Huang; Li Zhang; Bingyao Kang; Tingting Zhu; Yafei Li; Fengyan Zhao; Yi Qu; Dezhi Mu Journal: PLoS One Date: 2017-09-20 Impact factor: 3.240
Authors: Tina Dempsey; Huong Lien Nguyen; Huong Thu Nguyen; Xuan Anh Bui; Phuong Thi Thu Pham; Toan K Nguyen; Francesco Cavallin; Daniele Trevisanuto; Susanna Myrnerts Höök; Nicolas Pejovic; Mats Blennow; Linus Olson; Hien Vu; Anh Duy Nguyen; Tobias Alfvén Journal: Children (Basel) Date: 2022-02-28