Does Decreasing Mortality Increase Serious NeonatalNeurosensoric Morbidity?

Authors: M. Dokoupilová;  R. Plavka
Authors‘ workplace: Gynekologicko-porodnická klinika, Neonatologické oddělení s JIRP, 1. LF UK a VFN, Praha, přednosta doc. MUDr. P. Klener, DrSc.
Published in: Čes. Gynek.2003, , č. 5 s. 326-330


To investigate relation between the mortality and the incidence of serious neonatalneurosensoric morbidity in very low birth weight newborns (VLBWN, birth weigh < 1499 g) duringthe three periods as defined by different quality of the parinatal and neonatal care.Design: Retrospective analysis.Setting: Perinatal center of the General Faculty Hospital. 1st Medical Faculty Charles University,Prague.Subject and methods: All live-born VLBWN in 1987 - 2001 were divided according to their birth-dateto three five-year periods characterized by different quality of the perinatal and neonatal care.Ist period 1987 - 1991: the presurfactant aera with no standard use of antenatal steroids and withoutdefined border of the fetus viability; IInd period 1992 - 1996: the transient aera; IIIrd period 1997 -2001: the surfactant aera with standard use of the antenatal steroids, and defined border of the fetusviability. VLBWN were divided according to birth weight to three subgroups (p. h. < 750 g, p. h. = 750- 999 g, p. h. = 1000 - 1499 g).Mortality was defined by a death in our department until the discharge.VLBWnewborns classified as newborns with serious neonatal neurosensoric morbidity (NNsM) hadto have one of the following diagnoses at least: severe intraventricular haemorrhage (IVH gr. 3 - 4),posthemorhagic hydrocephaly (PHH), cystic periventricular leukomalacia (cPVL), meningitis, ventriculitis,encephalitis (M/E), retinopathy of prematurity > stage III (ROP > III st.). The 2 test wasused for statistic evaluation.Results: Therewere 873VLBWNborn and 208 of them died in thewhole period (1987 - 2001).Mortalitydecreased in 5 year periods gradually: Ist period 111/226 (49%); IInd period 55/217 (25 %); IIIrd period42/430 (10%). The decrease of mortality was significant in all weight categories (p < 0.001). Theincidence of NNsM was evaluated in 612 newborns and was similar in all periods regarding weightsubcategories < 1000 g, but decreased significantly in the weight category 1000 - 1499 g (14/215 (6%)vs 13/73 (18%), p < 0.01).Conclusion: Improvement in survival of extremely low birth-weight infants did not increase theincidence of serious neurosensoric morbidity and evenmore NNsM was reduced in haevier verypremature newborns during the nineties.

Key words:
very low-birth weight, mortality, neurosensoric morbidity, perinatal centers

Full text is not available online.
If interested in a scan of this journal, contact NTO ČLS JEP.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account