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Short Term Outcome and Predictors of Mortality Among Very Low Birth Weight Infants – A Descriptive Study

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Abstract

Objective

To assess the short term outcome and predictors of mortality among very low birth weight (VLBW) neonates.

Methods

This descriptive study from a tertiary care teaching institute in south India included 239 VLBW neonates who were uniformly managed as per unit’s protocol and followed up till discharge or death, whichever was earlier. Univariate analysis and logistic regression analysis were done to determine the predictors of mortality. Two logistic regression models were developed and to evaluate their discriminative performance, area under the receiver operating characteristic curves were calculated.

Results

Mean gestational age and mean birth weight of neonates were 31.4 ± 3 wk and 1191 ± 245 g respectively. Among the 239 infants, 49 (20.5%) expired and 190 (70.5%) survived. Mortality among extremely low birth weight (ELBW) and extreme preterm infants were 69.3% and 73.3% respectively. Univariate analysis showed multiple perinatal factors and neonatal morbidities were associated with mortality. On adjusted multivariate logistic regression, birth weight < 1000 g (OR 9.27), severe grade of intraventricular hemorrhage (IVH) (OR 29.2), hyperglycemia (OR 7.8) and respiratory distress syndrome (RDS) requiring surfactant therapy (OR 6.2) were the significant predictors of mortality. Both logistic regression models developed showed good prediction of mortality.

Conclusions

VLBW mortality rate is 20% in the population studied. Birth weight < 1000 g, severe grade of IVH, hyperglycemia, and RDS requiring surfactant therapy were the significant predictors of mortality among VLBW neonates. Both prediction models developed showed good prediction of mortality.

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Authors and Affiliations

  1. Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006, India

    Sushil Gupta, B. Adhisivam & Nishad Plakkal

  2. Professor of Pediatrics and Neonatology, AVMC, Pondicherry, India

    B. Vishnu Bhat

  3. Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India

    R. Amala

Authors
  1. Sushil Gupta
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  2. B. Adhisivam
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  3. B. Vishnu Bhat
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  4. Nishad Plakkal
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  5. R. Amala
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Contributions

SG: Collected and analyzed the data and drafted the manuscript; BA: Conceived the study and edited the manuscript; BVB: Monitored the study and edited the manuscript; NP: Helped with statistics and critical analysis; RA: Helped with statistics. BA will act as guarantor for this paper.

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Correspondence to B. Adhisivam.

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Gupta, S., Adhisivam, B., Bhat, B.V. et al. Short Term Outcome and Predictors of Mortality Among Very Low Birth Weight Infants – A Descriptive Study. Indian J Pediatr 88, 351–357 (2021). https://doi.org/10.1007/s12098-020-03456-z

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  • DOI: https://doi.org/10.1007/s12098-020-03456-z

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