Improvements in Neonatal Care have Increased Survival Rates for Very Low Birth Weight Infants

Abstract

Researchers compared outcome data on 1804 very low birth weight infants born at centers in Ohio Alabama Florida Tennessee Texas Vermont and New Hampshire during 1989-1990 with those born at the same centers during 1987-1988 to determine whether recent changes in neonatal care contributed to improvements in their survival rates. These changes included use of prenatal steroids cesarean delivery steroids to treat chronic lung disease and surfactant to treat respiratory distress syndrome. 78% of infants born during 1989-1990 lived until discharge to home or to a long-term care facility. During both periods the survival rate increased with birth weight (1989-1990 39% for newborns 90% of newborns >1000 g). Increased survival was greatest among infants weighing no more than 900 g at birth. The survival rates for these infants were 11-27% higher during 1989-1990 than during 1987-1988 especially among infants weighing 601-700 g. Survival rates also increased with gestational age during both periods. The increased survival rates during 1989-1990 were greatest among infants born at 24-26 weeks gestation. The prevalence of bronchopulmonary dysplasia (BPD) for very low weight infants born during 1989-1990 was 11%. BPD was inversely related to birth weight (35% for smallest infants to 3% among the largest infants). The incidence of serious neonatal complications among very low birth weight infants was low (22%). These findings suggest that changes in neonatal care may have indeed contributed to improvements in survival of very low birth weight infants.