Recent Outcome of Extremely Low Birth Weight Infants at Asan Medical Center

Kim, Jin Taek; Park, Hyun Kyung; Jun, Nu Lee; Lim, Jae Woo; Kim, Ellen Ai Rhan; Kim, Ki Soo; Pi, Soo Young

Abstract

PURPOSE
Survival rate of infants weighing less than 1, 000 g has been increased due to advanced neonatal care. We evaluated the outcome of extremely low birth weight (ELBW) infants who were born at Asan Medical Center. METHODS: We retrospectively reviewed survival, morbidities, and catch-up growth of the 105 ELBW infants from 1999 to 2002. RESULTS: Overall survival rate of ELBW infants was 65.7%. In respect to birth weight, the survival rates for <600 g, 600-699 g, 700-799 g, 800-899 g, 900-999 g were 22.2%, 38.5%, 64.3%, 70.4%, 89.3%, respectively. According to gestational age, <25 week, 25-27 week, 28-30 week, 31-33 weeks by gestational age, the survival rates were 26.7%, 68.3%, 76.9%, 100%, respectively. The mortality was 41.7% within one week of life. Among ELBW survivors, durations of hospitalization, O2 supply, and ventilatory support were 92.2+/-23.9 day, 36.9 +/- 26.5 day, 24.8 +/- 20.3 day, respectively. The incidences of respiratory distress syndrome, chronic lung disease and patent ductus arteriosus were 52.2%, 68.1%, 47.8%, respectively. The incidences of severe intraventricular hemorrhage > or = grade III, periventricular leukomalacia, severe retinopathy of prematurity > or = stage III and clinical or proven sepsis were 8.7%, 4.3%, 47.8%(n=33), 69.6%, respectively. 29 infants required laser photocoagulation due to retinopathy of prematurity. Duration of total parenteral nutrition (TPN) was 44.0 +/- 22.3 days. The incidences of TPN-associated cholestasis and necrotizing enterocolitis were 34.8%, 7.2%, repectively. At 18 months, 78.3% of ELBW infants showed catch-up growth. CONCLUSION: Survival rate of ELBW infants was 65.7%, which was much improved but lower than that of western and Japanese outcome. Further efforts must be made to increase their survival rates and to reduce morbidities.