American Journal of Obstetrics and Gynecology
ResearchObstetricsTrends in neonatal morbidity and mortality for very low birthweight infants
Section snippets
Materials and Methods
The present study compared perinatal information, morbidities, and mortality for 3 cohorts of infants born at participating centers (hereafter called “inborn infants”), all with birthweights between 501 and 1500 g. Cohort I comprises births in 1990 and 1991, the immediate postsurfactant era. Cohort II, comprising births in 1995 and 1996, reflects the sharp increase in antenatal corticosteroid use. Cohort III, with 18,153 infants, covers the period from 1997 to 2002.
All the infants were part of
Survival and morbidity
Mortality and selected morbidities among VLBW infants were compared for the 3 cohorts (1990-1991, 1995-1996, and 1997-2002), using data only from the 12 centers that had participated in the Network throughout this period. Mortality for the entire cohort declined from 20% in the 1990-1991 cohort to 16% (relative decline 20%, P < .0001) in the 1995-1996 cohort, and 15% (relative decline 6%, P = .9117) in the 1997-2002 cohort. Most deaths occurred within 7 days of birth, and 87% of VLBW infants
Comment
This report summarizes the mortality and morbidity among VLBW infants born at the Neonatal Research Network centers (listed under Acknowledgments) between 1997 and 2002. Comparison of outcomes for the full period from 1990 to 2002 is restricted to the 12 centers that participated throughout the 13 years. Between January 1997 and December 2002, 85% of inborn VLBW infants survived to discharge, ranging from 55% of infants who were 501-750 g at birth to 96% for infants 1250-1500 g at birth;
Acknowledgments
Membership of the NICHD Neonatal Research Network is as follows (principal investigators are indicated by an asterisk).
Chairman: Alan Jobe,* MD, University of Cincinnati
Case Western Reserve University (U10 HD021364): Avroy A. Fanaroff,* MD; Michele C. Walsh, MD; Nancy Newman, RN
University of Cincinnati (U10 HD027853, M01 RR008084): Edward F. Donovan,* MD; Marcia Mersmann, RN
Emory University (U10 HD027851): Barbara J. Stoll,* MD; Ellen Hale, RN
Indiana University (U10 HD027856, M01 RR000750):
References (38)
- et al.
Very-low-birth-weight outcomes of the National Institute of Child Health and Human Developmental Neonatal Network, November 1989 to October 1990
Am J Obstet Gynecol
(1995) - et al.
Very-low-birth-weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, May 1991 through December 1992
Am J Obstet Gynecol
(1995) - et al.
Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1993 through December 1994
Am J Obstet Gynecol
(1998) - et al.
The Preterm Prediction Study: the value of serum alkaline phosphatase, α-fetoprotein, plasma corticotropin-releasing hormone, and other serum markers for the prediction of spontaneous preterm birth
Am J Obstet Gynecol
(2002) - et al.
Outcomes of children of extremely low birth weight and gestational age in the 1990s
Semin Neonatol
(2000) - et al.
New Ballard Score, expanded to include extremely premature infants
J Pediatr
(1991) - et al.
Inaccuracy of Ballard scores before 28 weeks gestation
J Pediatr
(1999) - et al.
Necrotizing enterocolitis: treatment based on staging criteria
Pediatr Clin North Am
(1986) - et al.
A United States national reference for fetal growth
Am J Obstet Gynecol
(1996) - et al.
Risk factors for early death among extremely low-birth-weight infants
Am J Obstet Gynecol
(2002)
Very low birth weight outcomes of the National Institute of Child Health and Human Developmental Neonatal Network
Pediatrics
Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 through December 1996
Pediatrics
Trends in mortality and morbidity for very low birth weight infants, 1991-1999
Pediatrics
Annual summary of vital statistics: 2001
Pediatrics
Annual summary of vital statistics: 2000
Pediatrics
Annual summary of vital statistics: 2003
Pediatrics
Frequency of uterine contractions and the risk of spontaneous preterm delivery
N Engl J Med
Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993-1994
Pediatrics
Neurologic and developmental disability after extremely preterm birth
N Engl J Med
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Supported by a grant from the National Institutes of Health, National Institute of Child Health and Human Development, through cooperative agreements with the authors’ institutions U01 HD036790, U10 HD021364, U10 HD021373, U10 HD021385, U10 HD021397, U10 HD021415, U10 HD027851, U10 HD027853, U10 HD027856, U10 HD027871, U10 HD027880, U10 HD027881, U10 HD027904, U10 HD034167 U10 HD034216, and U10 HD040689, and General Clinical Research Centers M01 RR000070, M01 RR000750, M01 RR000997, M01 RR001032, M01 RR002172, M01 RR002635, M01 RR006022, and M01 RR008084.
Cite this article as: Fanaroff AA, Stoll BJ, Wright LL, et al; NICHD Neonatal Research Network. Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol 2007;196:147.e1-147.e8.