Improved Survival and Survival Without Bronchopulmonary Dysplasia in Very Low Birth Weight Infants after Active Perinatal Care

Abstract

Background: Perinatal and neonatal care for very low birth weight (VLBW) infants have changed significantly during the past two decades.  However, it is unclear how these changes have affected neonatal mortality and morbidity in developing countries.

Objectives: The aim of this study was to investigate the impact of the advanced neonatal care on short‑term outcomes of VLBW infants.

Methods: A retrospective study was performed to compare the mortality and morbidity of VLBW infants between period I (2007‑2011) and period II (2012‑2016) in our unit.

Results: A total of 188 infants in period I and 214 infants in period II were evaluated. The overall in‑hospital mortality for VLBW infants dropped  from 26.1% in period I to 13.1% in period II. The incidence of birth asphyxia decreased significantly during period II (10.1% [period I] vs 3.7% [period II]). The rate of nasal continuous positive airway pressure (NCPAP) use (69.8% vs 87.1%) and the duration of NCPAP therapy (median: 3 days [period I] vs 5 days [period II]) increased significantly, while the proportion of infants treated with mechanical ventilation and the duration of mechanical ventilation significantly decreased. There was a significant increase in the proportion of survivors without major neonatal morbidity, mainly due to a significant increase in the incidence of survival without bronchopulmonary dysplasia (BPD) (72.7% vs 82.8%). In contrast, the incidence of late‑onset sepsis increased significantly during period II (7.9% vs 19.4%).

Conclusions: Active perinatal care is associated with improvements in survival and survival free of BPD for VLBW infants. However, late‑onset sepsis  is still a major concern.

Keywords: Morbidity, mortality, perinatal care, prematurity, sepsis, very low birth weight