Rachana R D, Venkateshwarlu Vardhelli, Pallavi Chandra Ravula, Ridhima Gadepalli, Sireesha Tirumalaraju, Sruthi Nair, Sumayya Hafeez, Sruthi Thiruveedi, Sajal Das, Saikiran Deshabhotla, Tejo Pratap Oleti
Very preterm and VLBW infants demonstrated high survival with low rates of major morbidities. However, improvement in survival at lower gestational ages remains a key area for improvement.
OBJECTIVES: This study reports pre-discharge survival and clinical outcomes of very preterm infants (VPI) and very low birth weight (VLBW) infants from a tertiary-care, inborn neonatal unit in India.
METHODS: In this retrospective study, inborn neonates admitted between 2013 and 2022 over a 10-y period were included. VLBW group included infants with birth weight (BW) of 500-1499 g with GA ≥26 wk and VPI group included infants with 26⁰/₇-31⁶/₇ wk gestational age (GA). Infants with major congenital anomalies, inborn errors of metabolism, or those transferred to another hospital before completion of treatment were excluded.
RESULTS: A total of 2063 VLBW infants and 1663 VPI were analyzed. In the VLBW group, the mean GA and birth weight were 30.4 wk and 1173 g, respectively. Survival was 90.6% among VLBW infants and 76.9% among extremely low birth weight infants. Major morbidities included late-onset culture-positive sepsis (LOS: 18.1%), intraventricular hemorrhage (IVH) ≥ Grade II (7.1%), and retinopathy of prematurity (ROP) requiring treatment (2.2%). In the VPI group, mean GA and birth weight were 30.0 wk and 1180 g. Survival rates were 89.1% for VPI and 66.8% for the extremely preterm subgroup. Rates of LOS, IVH ≥ Grade II, ROP requiring treatment, and bronchopulmonary dysplasia in VPI were 20.9%, 8.8%, 2.5%, and 2.9%, respectively.
CONCLUSIONS: Very preterm and VLBW infants demonstrated high survival with low rates of major morbidities. However, improvement in survival at lower gestational ages remains a key area for improvement.