OUTCOME OF VLBW INFANTS WITH INITIAL HOSPITALIZATION GREATER THAN 40 WEEKS GESTATIONAL AGE

Abstract

Of 294 hospital survivors ≤1500g 103 (35%) were discharged after 40 weeks gestational age (mean gestational age at discharge for all survivors - 40 weeks (SD 4.2)). These long-stay survivors were divided into 3 groups: Gp 1, AGA ≤28 weeks; Gp 2, AGA >28 weeks and Gp 3, SGA. The proportions of long-stay survivors in the respective groups were 31%, 25% and 84%. Significant predictors of long-stay were SGA, 1-minute Apgar score <4 and admission base deficit >10. Compared to other groups,Gp 1 had increased neonatal respiratory morbidity, BPD, RLF and days in NICU. In the first 2 years they had more episodes of otitis media and more hospitalizations for respiratory problems. Cerebral palsy occurred in 13%. Long-stay survivors in Gp 2 had better 2-year growth percentiles but significantly more cerebral palsy (18%) and family disintegration. Long-stay survivors in Gp 3 had fewer neonatal complications,but lower growth percentiles. Significantly more post discharge deaths (6/8) occurred in long-stay survivors (6% vs 1%) and included 3 deaths from sepsis (Gps 1&3) and 3 deaths from SIDS (Gp 2). Mean Bayley scores at 2 years corrected age were: Gp 1 (MDI 89,PDI 85), Gp 2 (MDI 93, PDI 89), Gp 3 (MDI 96,PDI 91). Long-stay survivors have a differing neonatal course and outcome according to gestational age and prenatal growth, and continue to have increased morbidity and mortality in their first 2 years.

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