Analysis of survival and prognostic factors in extremely preterm infants

Abstract:

Objective To investigate the survival rate, complications during hospitalization, and prognostic factors in extremely preterm infants (gestational age less than 28 weeks) in the neonatal intensive care unit (NICU). Methods A retrospective analysis was performed on 90 extremely preterm infants who were admitted to the NICU between January 2011 and March 2013 to investigate the perinatal data, delivery and resuscitation, ventilation/ oxygen supply during hospitalization, mortality, and the incidence of severe (grade III/IV) intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), patent ductus arteriosus (PDA), and septicemia. Results Among the 90 extremely preterm infants, the gestational age, birth weight, overall survival rate, mortality, and withdrawal rate were 26±1 weeks, 898±165 g, 57%, 9%, and 34%, respectively. The incidence rates of neonatal respiratory distress syndrome, BPD, PDA, ROP, and grade III/IV IVH were 88%, 85%, 69%, 68%, and 31%, respectively. The surviving infants had a mean length of hospital stay of 83±18 days and a mean weight at discharge of 2419±300 g. The multivariate logistic regression analysis showed that grade III/IV IVH and pulmonary hemorrhage were high-risk factors for death or withdrawal, while antenatal corticosteroids were the protective factor for outcome (P<0.05). Conclusions The survival rate of extremely preterm infants is still much lower than that in developed countries. grade III/IV IVH, and pulmonary hemorrhage are important prognostic factors.