Survival of Premature and Low Birth Weight Infants: A Multicenter, Prospective, Cohort Study in Iran

Document Type : Original Article

Authors

1 Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

2 Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran

3 Tabriz Health Services Management Centre, Tabriz, Iran

4 Mashhad Omolbanin Hospital, Mashhad, Iran

5 Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran

Abstract

ABSTRACT
Background: The survival rate of preterm and low-birth-weight (LBW) infants depends on various factors such as birth weight, gestational age, and quality of care. The present study aimed at evaluating the survival rate of preterm and LBW infants, predictive factors, and the risk of mortality in three training hospitals of Mashhad and Tabriz cities.
Methods: This prospective, cohort study was conducted during six months from 2013 to 2014. Infants with birth weight ≤1500 g or gestational age ≤32 weeks were enrolled. Their information was gathered by using data collection forms and clinical risk index for infants (CRIB II) was calculated for each participant. Infants were followed up until discharge from the hospital and their outcomes were determined. Kaplan-Meier and Log rock tests were used for survival analysis. Cox regression was also applied in order to find out the factors associated with infants’ survival.
Results: Among the 338 followed up infants, 97 (28.7%) died and 241 (71.3%) remained alive. The median of preterm and LBW infants’ overall survival rate was 76 days (CI: 60.4-91.5). Multivariate Cox regression analysis indicated that three factors of birth weight, base excess, and fifth minute Apgar score had a significant relationship with the survival rate of infants (P<0.05).
Conclusion: The survival rate of preterm and low-weight infants was acceptable in this study (71%). Birth weight, fifth minute Apgar score, and base excess were important items that affected infants’ survival and could be considered in predicting it in neonatal intensive care units.

Keywords

References

References
1. Verklan MT, Walden M. Core curriculum for neonatal intensive care nursing. New York: Elsevier Health Sciences; 2014.
2. Hashemian Nejad N, Pejhan A, Rakhshani MH, Hoseini BL. The incidence of low birth weight (LBW) and small-for-gestational age (SGA) and its related factors in neonates, Sabzevar, Iran. Int J Pediatr. 2014; 2(4.2):73-8.
3. Platt M. Outcomes in preterm infants. Public Health. 2014; 128(5):399-403.
4. Kliegman RM. Nelson textbook of pediatrics. Philadelphia: Sunders; 2011.
5. Lau C, Ambalavanan N, Chakraborty H, Wingate MS, Carlo WA. Extremely low birth weight and infant mortality rates in the United States. Pediatrics. 2013; 131(5):855-60.
6. Rüegger C, Hegglin M, Adams M, Bucher H. Population based trends in mortality, morbidity and treatment for very preterm-and very low birth weight infants over 12 years. BMC Pediatr. 2012; 12(1):17.
7. Vakrilova V. Scoring systems for assessing illness severity and predicting outcome in very low birth weight infants. Akush Ginekol. 2011; 50(1):37-41.
8. Basu S, Rathore P, Bhatia BD. Predictors of mortality in very low birth weight neonates in india. Singapore Med J. 2008; 49(7):556-60.
9. Khani S, Mohamadpour RA, Ghaffari Saravi V, Abdollahi F, Sabaghi R, Bavand M. 200 and governmental hospitals in Sari by survival analysis technique during 2005-7. J Mazandaran Univ Med Sci. 2008; 17(62):54-62.
10. Alleman BW, Bell EF, Smith B, Ambalavanan N,
Laughon MM, Stoll BJ, et al. Individual and center-level factors affecting mortality among extremely low birth weight infants. Pediatrics. 2013; 132(1):e175-84.
11. Sritipsukho S, Suarod T, Sritipsukho P. Survival and outcome of very low birth weight infants born in a university hospital with level II NICU. J Med Assoc Thai. 2007; 90(7):1323-9.
12. Selected finding of the 2011 national population and housing Census. Statistical Centre of Iran ISY. Available at: URL: http://unstats.un.org/unsd/demographic/sources/census/wphc/Iran/Iran-2011-Census-Results.pdf; 2011.
13. Rezaeian A, Boskabadi H, Mazlom SR. Factors associated with perinatal mortality in preterm infants in NICU Ghaem Hospital, Mashhad. J North Khorasan Univ Med Sci. 2012; 4(3):349-60.
14. Medlock S, Ravelli AC, Tamminga P, Mol BW, Abu-Hanna A. Prediction of mortality in very premature infants: a systematic review of prediction models. PloS One. 2011; 9(6):e23441.
15. Zanjani AP, Gharib MH, Kamrani MA. The evaluation of predicting mortality risk of premature infants with very low birthweight by CRIB score. J Gorgan Univ Med Sci. 2009; 10(4):40-3.
16. Manuck TA, Rice MM, Bailit JL, Grobman WA, Reddy UM, Wapner RJ, et al. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obstet Gynecol. 2016; 215(1):103.e1-14.
17. Costeloe K, Hennessy E, Haider S, Stacey F, Marlow N, Draper ES. Short-term outcomes after extreme preterm birth in England: comparison of 2 birth cohorts in 1995 and 2006 (the EPICure studies). BMJ. 2012; 345:e7976.
18. Navaei F, Aliabady B, Moghtaderi J, Moghtaderi M, Kelishadi R. Early outcome of preterm infants with birth weight of 1500 g or less and gestational age of 30 weeks or less in Isfahan city, Iran. World J Pediatr. 2010; 6(3):228-32.
19. Velaphi SC, Mokhachane M, Mphahlele RM, Beckh-Arnold E, Kuwanda ML, Cooper PA. Survival of very-low-birth-weight infants according to birth weight and gestational age in a public hospital. S Afr Med J. 2005; 95(7):504-9.
20. Mohamed EM, Soliman AM, El-Asheer OM. Predictors of mortality among neonates admitted to neonatal intensive care unit in pediatric Assiut University Hospital, Egypt. J Am Sci. 2011; 7(6):606-11.
21. Babaee H, Jafrasteh A. The evaluation of CRIBII scoring system in predicting mortality in preterm
newborns. Yafteh. 2015; 16(4):27-35 (Persian).
22. Rastogi PK, Sreenivas V, Kumar N. Validation of CRIB II for prediction of mortality in premature babies. Indian Paediatr. 2010; 47(2):145-7.
23. Locatelli A, Roncaglia N, Andreotti C, Doria V, Doni D, Pezzullo JC, et al. Factors affecting survival in infants weighing 750g or less. Eur J Obstet Gynecol Reprod Biol. 2005; 123(1):52-5.
24. Mori R, Shiraishi J, Negishi H, Fujimura M. Predictive value of Apgar score in infants with very low birthweight. Acta Paediatr. 2008; 97(6):720-3.
25. Vincer MJ, Armson BA, Allen VM, Allen AC, Stinson DA, Whyte R, et al. An algorithm for predicting neonatal mortality in threatened very preterm birth. J Obstet Gynaecol Can. 2015; 37(11):958-65.
26. Ravelli AC, Schaaf JM, Mol BW, Tamminga P, Eskes M, van der Post JA, et al. Antenatal prediction of neonatal mortality in very premature infants. Eur J Obstet Gynecol Reprod Biol. 2014; 176:126-31.
27. Fallahi M, Joudaki N, Bandpey HM. Evaluation of
causes of neonatal mortality in Shohadaye Tajrish hospital, during years 2004-2007. Pajoohandeh. 2009; 14(1):43-6. (Persian)
28. Olischar M, Messerschmidt A, Repa A, Klebermasz-Schrehof K, Weber M, Pollak A, et al. The early prediction of neonatal morbidity and mortality in singleton small for gestational age infants with a birthweight
Iranian Journal of Neonatology
Volume 8, Issue 1
March 2017
Pages 16-22

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