Effect of Birth Weight, Gestational Age, Sex and Intrauterine Growth on Mortality and Morbidity Profile of very Low Birth Weight Babies(VLBW)

Abstract

Introduction: Very Low birth weight is associated with serious neonatal morbidity. Biologic factors are major determinants in their outcome. We analysed the effect of birth-weight, gestation, sex and intrauterine growth in the mortality and morbidity profile of VLBW babies during the neonatal period. Methodology: This is a cross sectional retrospective observational study from April-2012 to August-2014. Baseline demographics, disease features of 97 VLBW babies were analyzed. Results: Survival at discharge was 91.75%. There was significant difference in need of ventilation, surfactant, Apnea, ROP, IVH >/= Grade-II, Culture-negative Sepsis among all gestational subgroups. Survival increased as gestation advanced. Maximum decrease in mortality has occurred beyond 28 weeks. Maximum odds difference in need of ventilation, BPD was noted around 28 weeks. Major difference in HS-PDA, IVH, NEC were noted around 30 weeks. Significant difference in need of surfactant, apnea and anemia was observed around 32 weeks. Major decrease in HMD, Hyperbirubinemia and sepsis were identified around 34 weeks. Analysing intrauterine growth, Significant difference in Need of ventilation, surfactant use, IVH, NEC, Anemia and death was noted between AGA and SGA. Analysing birth weight wise, Survival improved as birth-weight increased. There was significant difference in HS-PDA and IVH in all birth-weight subgroups. Maximum decrease in death was noted in babies >1000g. Maximum odds difference in BPD, Apnea, Hyperbilirubinemia, IVH, Anemia, ROP and culture negative sepsis occured around 800g. Major difference in HMD, NEC, Culture positive sepsis was observed around 1000g. Significant odds difference in HS-PDA occurred around 1200g. Maximum decrease in need of surfactant and ventilation was noted around 1400g. Conclusion: There was no difference between male and female in survival or morbidities. Survival improved with advancing Gestation, Intrauterine growth and Birth-weight. Analysing intrauterine growth, Significant difference in Need of ventilation, surfactant, IVH, NEC, Anemia and death was noted between AGA and SGA. Significant variations in morbidity profile were noted among birth weight and gestational age subgroups.