Changing outcome of extremely premature infants (less than 26 weeks gestation and 750 grams): survival and follow-up at a tertiary center

Article Abstract:

The prognosis for premature infants has improved substantially, but may not apply to very premature infants born before 26 weeks gestation who weigh less than 750 grams (1.65 lbs). Treatment of very premature infants is debatable because the survival rates have not been established. To determine survival rates the authors evaluated 175 very premature infants admitted to the neonatal intensive care unit from 1981 to 1987. Ninety-one percent of these infants were delivered in the hospital, and 73 infants survived. In 1981-1982 survival increased from 21 percent to greater than 50 percent in 1986-1987. Most of the deaths occurred within 48 hours after birth; death rarely occurred after 28 days of life. When these infants were followed-up half were normal, 27 had mild to moderate abnormalities and 23 percent were severely impaired. Improved survival did not increase the incidence of impairment. Infants previously considered nonviable are offered better chances of survival with new neonatal technology.

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Recent changes in delivery site of low-birth-weight infants in Washington: impact on birth weight-specific mortality

Article Abstract:

An apparent shift of deliveries of low-birth-weight infants from tertiary hospitals to less-equipped hospitals may raise the mortality rates and undermine regionalized health care for high-risk infants. Researchers retrospectively analyzed place of birth and mortality rates of infants weighing 500 to 2,499 grams at birth in Washington state between 1980 and 1991. The number of low-birth-weight infants born at tertiary hospitals, which provide the most extensive care, rose between 1980 and 1988. After 1988, the rate of low-birth-weight infants delivered at tertiary hospitals dropped, and the rate born at nontertiary hospitals rose. The preventable mortality rate of these infants also rose. Health care reform should not compromise regionalization of infant health care in an attempt to control costs.

Research, Management, Birth weight, Low, Low birth weight, Hospital utilization

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Perinatal care regionalization and low birth weight infant mortality rates in Alaska

Article Abstract:

Premature babies may receive good care at smaller hospitals that do not have a neonatal intensive care unit, according to a study of 2,809 babies who were born in Alaska between 1993 and 1997. During this time period, only one hospital in Alaska provided advanced obstetrics and neonatal services.

United States, Alaska, Hospitals, Gynecologic and obstetric, Gynecologic and obstetric hospitals

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