BACKGROUND AND PURPOSE:

• There is limited data on extremely low birthweight newborns
• Bashir et al. (Am J Perinatol, 2017) describe survival, short-term, and long-term morbidities of neonates < 500g

METHODS:

• Retrospective cohort study
• Neonatal Follow-Up Program (NFUP) at British Columbia’s Women’s Hospital and Health Centre (BCWH)
  • Prospectively enrolls neonates with birth weight ≤ 800 g
  • Conducts multidisciplinary neurodevelopmental assessments at ages 4, 8, and 18 months corrected age (CA), and at 3 and 4.5 years chronological age since 1983
  • The first survivor with birth weight < 500 g was born in 1985
• Primary objectives
  • Calculated survival and morbidity rates as well as neurodevelopmental impairment rates at 4.5 years of neonates < 500g
• Secondary objective
  • Compare outcomes of small for gestational age (SGA) infants against entire cohort where <500 g is appropriate for gestational age

RESULTS:

• Data from 549 neonates with birth weight < 500g was collected
• Among liveborns
  • 180 (83%) died in the delivery room
  • 17 (8%) died in the NICU
  • 21 (10%) survived
• Among all births, 3.8% (21/549) survived
• Of NICU survivors
  • Median birth weight was 460 g
  • Median gestational age was 25.9 weeks (range: 22.6-30.3 weeks)
  • 71% were inborn | 50% male | 75% were SGA
• 20% were a twin or multiple
• Complications – Leading Short Term Morbidities
  • Branchopulmonary dysplasia (91%)
  • Culture proven sepsis (50%)
  • Retinopathy of prematurity (41%)
  • Severe brain injury (22%)
• Complications – Long Term Morbidities
  • 27% had no long-term impairment
  • 23% had one, 23% had two, 18% had three, and 9% had four impairments in motor, cognitive, vision, and/or hearing domains
• At 4.5 years
  • 29% had visual impairment
  • 10% wore hearing aids
  • 50% had an IQ <70
  • 18% cerebral palsy
  • 68% had low motor scores

CONCLUSION:

• Approximately 4% of births <500 g survived, with all survivors having short-term morbidities
• 27% of neonates survived without long-term impairment

Learn More – Primary Sources:

Survival, Short-Term, and Long-Term Morbidities of Neonates with Birth Weight < 500 g

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