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Abstract
Background: Caring about ELBW newborns at the limit of viability is demanding with a high rate of mortality and long-term morbidity. Society expectations become high and persistent while health care coast inside NICU is very high. Objective: The purpose of this study is to examine the short-term survival (till discharge) of extremely low birth weight (ELBW) newborns at limits of viability 23–26 weeks gestation (WG) age in a large tertiary maternity hospital. Methods: A population-based retrospective study of babies born at 23–26 WG age over 3 years period. Results: Over the study period 2016 to mid-2018, a total of 283 ELBW newborns were delivered in our institute. Of those, 250 were admitted to NICU (88%). The number of newborns who survived till discharge from NICU was 174 (61.5%) while the rate of delivery room death was 33 newborns (11.75%). The survival rates during 2016–2018 period were 35%, 64%, 73%, and 81.4% for 23, 24, 25, and 26 WG respectively. 76 newborns (26.9%) of NICU admissions died before discharge. Most deaths occurred during the first two weeks of life (64%). The main cause of death inside the NICU during the first 2 weeks was respiratory failure, followed by infection. Conclusion: Counseling Parent using local data become more convincing and reflecting local experience. Short term survival rate of ELBW is comparable to those reported in the literature. The first two weeks are very crucial where the mortality rate is highest.
Highlights
Periviability is defined as the ability for a fetus to survive outside the uterus post-birth
Over the study period 2016-2018, a total of 3493 premature newborns 36 weeks and less were admitted to our Neonatal Intensive Care Unit (NICU)
A 283/3493 (8%) extremely low birth weight (ELBW) newborns of gestation age 23-26 weeks were delivered in our institute and included in the study (Fig-1)
Summary
Periviability is defined as the ability for a fetus to survive outside the uterus post-birth. Infants born at 26 weeks of gestational age and above are considered to have high extrauterine chances of survival [1,2,3]. An extremely premature baby costs an average of 62,000 USD during hospitalization in the WWRC depending on the gestational age. Caring about ELBW newborns at the limit of viability is demanding with a high rate of mortality and long-term morbidity. Objective: The purpose of this study is to examine the short-term survival (till discharge) of extremely low birth weight (ELBW) newborns at limits of viability 23–26 weeks gestation (WG) age in a large tertiary maternity hospital. The number of newborns who survived till discharge from NICU was 174 (61.5%) while the rate of delivery room death was 33 newborns (11.75%). The first two weeks are very crucial where the mortality rate is highest
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