Very-low-birth-weight infant outcomes in 11 South American NICUs.

Abstract

To describe and analyze outcomes in very-low-birth-weight (VLBW) infants treated in 11 Neonatal Intensive Care Units (NICUs) from four South American countries. This study is the first of a multination collaboration and can serve as a baseline for future quality and resource utilization efforts. Biodemographic data and multiple outcome measures were prospectively collected from October 1997 until August 1998. A logistic regression model was used to define risk factors in primary outcome measures, death, and bronchopulmonary dysplasia (BPD). Center differences were compared using chi-squared analysis. In 385 VLBW infants enrolled, mortality rate was 27%, with a range from 11% to 51% among NICUs. A lower BW, lower gestational age (GA), lack of antenatal steroids (AS), and air leaks (AL) were associated with increased risk of death. A lower BW, lower GA, AL, need for surfactant, necrotizing enterocolitis, and need for intubation were associated with increased risk of BPD. This study provides actual information about VLBW infants' prognosis in a SA region. Mortality rate variability among NICUs may be explained by differences in population and resources, but also by lack of implementation of proven beneficial therapies such as AS administration.