摘要
Aim: To report survival and morbidity until discharge in preterm infants < 50 1 g with life support started immediately after birth. Methods/study design: Coh ort study of all preterm infants with birthweights < 501 g born in three tertiary perinata l centres between 1 January 1998 and 31 December 2001 (gestational age (GA) 25.2 [21.0- 30.7] wk; birthweight 435 [290- 500] g; median [range]). Results: A to tal of 107 infants with birthweights < 501 g were born. Twenty- nine were still born. A prenatal decision to initiate life support immediately after birth was r eached in 9/37 (24% ) infants < 24.0 wk GA and in 39/42 (93% ) infants ≥ 24. 0 wk GA. Survival was 3/37 (8% ) and 26/41 (63% ) in infants < 24 wk GA and ≥ 24.0 wk GA, respectively. Twenty- nine of the 48 infants with immediate life support (60% ) survived (95% CI: 46- 75% ). Forty- two of these 48 (88% ) infants were small for gestational age. No infant without immediate life suppor t survived (0/30). Twenty- three (79% ) survivors developed chronic lung disea se (CLD) and eight (28% ) received photocoagulation for retinopathy of prematur ity (ROP). Conclusion: In this population of extremely low birthweight infants, survival was higher than in previous studies when life support was provided imme diately after birth. Short- term morbidity was similar to other studies. The pr esented data on survival support our concept to offer immediate life support aft er birth in preterm infants with birthweights< 501 g. The long- term outcome of these infants needs to be assessed urgently.
Aim: To report survival and morbidity until discharge in preterm infants < 50 1 g with life support started immediately after birth. Methods/study design: Coh ort study of all preterm infants with birthweights < 501 g born in three tertiary perinata l centres between 1 January 1998 and 31 December 2001 (gestational age (GA) 25.2 [21.0- 30.7] wk; birthweight 435 [290- 500] g; median [range]). Results: A to tal of 107 infants with birthweights < 501 g were born. Twenty- nine were still born. A prenatal decision to initiate life support immediately after birth was r eached in 9/37 (24% ) infants < 24.0 wk GA and in 39/42 (93% ) infants ≥ 24. 0 wk GA. Survival was 3/37 (8% ) and 26/41 (63% ) in infants < 24 wk GA and ≥ 24.0 wk GA, respectively. Twenty- nine of the 48 infants with immediate life support (60% ) survived (95% CI: 46- 75% ). Forty- two of these 48 (88% ) infants were small for gestational age. No infant without immediate life suppor t survived (0/30). Twenty- three (79% ) survivors developed chronic lung disea se (CLD) and eight (28% ) received photocoagulation for retinopathy of prematur ity (ROP). Conclusion: In this population of extremely low birthweight infants, survival was higher than in previous studies when life support was provided imme diately after birth. Short- term morbidity was similar to other studies. The pr esented data on survival support our concept to offer immediate life support aft er birth in preterm infants with birthweights< 501 g. The long- term outcome of these infants needs to be assessed urgently.
