Perinatal factors affecting survival of very low birthweight infants — a study from two hospitals

ABSTRACT. Three hundred and seventy-seven consecutive liveborn infants with a birthweight between 500g and 1500g born at two perinatal centres in the calendar years 1977 and 1978 and 40 outborn infants in the same weight group admitted to one of the hospitals during the same period were studied. Although the survival rates in individual 100g weight groups vary between 14.3% and 97.4%, overall survival rates for inborn and outborn infants in both hospitals were similar, ranging from 69.0% to 71.5%. Twenty-two perinatal factors were found to have a significant effect on survival, of which 15 were common to the inborn populations in both hospitals. Eight of these 22 factors were indicators of intrapartum asphyxia. Multiple regression analysis showed that whereas birthweight was the most important variable influencing outcome in one hospital, the infant's condition at birth is the most important in the other. This difference may be related to the aggressive approach to perinatal intensive care of extremely preterm infants in the latter hospital.     

Spanish population‐study shows that healthy late preterm infants had worse outcomes one year after discharge than term‐born infants

Aim

This study assessed the risks associated with healthy late preterm infants and healthy term‐born infants using national hospital discharge records.

Method

We used the minimum basic data set of the Spanish hospital discharge records database for 2012–2013 to analyse the hospitalisation of newborn infants. The outcomes were in‐hospital mortality and hospital re‐admissions at 30 days and one year after their first discharge.

Results

Of the 95 011 newborn infants who were discharged, 2940 were healthy late preterm infants, born at 34 + 0–36 + 6 weeks, and 18 197 were healthy term‐born infants. The mean and standard deviation (SD) length of hospital stay were 6.0 (4.5) days in late preterm infants versus 2.8 (1.3) days in term‐born infants (p < 0.001). Re‐admissions were also higher in the late preterm group at 30 days (9.0% versus 4.4%) and one year (22.0% versus 12.4) (p < 0.001). The relative risk for death at one year was 4.9 in the late preterm group, when compared to the term‐born infants (p = 0.026).

Conclusion

The hospital discharge codes for otherwise healthy newborn preterm infants were associated with significantly worse 30‐day and one‐year outcomes when their re‐admission and mortality rates were compared with healthy term‐born newborn infants.