A population study. Mortality and morbidity after availability of surfactant therapy. Newborn Lung Project.
Arch Pediatr Adolesc Med
; 148(12): 1295-301, 1994 Dec.
Article
em En
| MEDLINE
| ID: mdl-7951809
ABSTRACT
OBJECTIVE:
To assess the impact of recent changes in neonatal intensive care on the mortality and morbidity of very-low-birth-weight neonates (< 1501 g).DESIGN:
Prospective cohort study.SETTING:
Six neonatal intensive care units in Wisconsin and Iowa.PARTICIPANTS:
All very-low-birth-weight neonates who were admitted to the neonatal intensive care units the year before the availability of exogenous surfactant (n = 333), during the investigational new drug protocol for synthetic surfactant (Exosurf) (n = 347), and after the release of synthetic surfactant (n = 356) (designated as periods 1, 2, and 3, respectively).INTERVENTIONS:
None. MAINRESULTS:
The percentage of neonates receiving exogenous surfactant in the three periods was 3%, 37%, and 56%, and the percentage receiving antenatal steroids was 12%, 17%, and 27% (P = .0001 for increase in both modalities). The percentage of neonates dying in the three periods was 23%, 14%, and 19% (P = .05 for downward trend). The percentage of neonates with intraventricular hemorrhage decreased in the subgroup weighing between 700 and 1350 g (35%, 28%, and 24%) (P = .04) and increased in the subgroup weighing below 700 g (8%, 41%, and 45%) (P = .03). The percentage of neonates with bronchopulmonary dysplasia increased from 21% to 36% between periods 1 and 2 (P = .003) and decreased to 27% (P = .04) in period 3. Antenatal steroid use was strongly associated with the decrease in intraventricular hemorrhage (odds ratio, 0.35) and mortality risk (odds ratio, 0.20).CONCLUSIONS:
Several developments in care have contributed to changes in mortality risk, incidence of intraventricular hemorrhage, and the severity of respiratory disease in very-low-birth-weight infants.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tensoativos
/
Recém-Nascido de Baixo Peso
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
/
Newborn
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Arch Pediatr Adolesc Med
Assunto da revista:
PEDIATRIA
Ano de publicação:
1994
Tipo de documento:
Article