Morbidity and mortality rates of very low birth weight infants in Akdeniz University Hospital in between january 2009 - december 2013

In recent years, improvements in medical care have been associated with a significant increase and better outcome of very preterm (VP, < 32 completed gestational weeks) and very low birth weight (VLBW, ≤ 1500 g) infants. Our goals were to determine the morbidity and mortality rates of infants weighing 501 to 1500 g according to gestational age, birth weight, and gender and to document birth weight-related changes in mortality and morbidity over a 5-year time period. Biodemographic data and multiple outcome measures of very low birth weight infants (≤ 1500 g) were retrospectively collected from January 1st, 2009 until December 31st, 2013 in our hospital. In this study, 306 VLBW infants were compatible with our study criteria were evaluated and mortality rate was 27.5%. Patients included in our study were divided into four groups according to birth weight. Patients ≤750 g constituted group 1, patients with a birth weight of 751-1000 g constituted group 2, patients with a birth weight of 1001-1250 g constituted group 3 and patients with a birth weight of 1251-1500 g constituted group 4. Morbidity and mortality rates were compared between these groups. Mortality among infants ≤750 g was 75%; among infants 751 to 1000 g, 40%; among infants 1001 to 1250 g, 15.6%; among infants 1251 to 1500 g, 1%. Mortality decreased steadily with increasing birth weight, which was statistically significant (p <0.05). Mean gestational age of survived infants was 29.3 weeks. For death infants, mean gestational age was 26.2 weeks. The mortality rates were 85.1% at 22-24 weeks gestation, 53.8% at 25-26 weeks, 26.1% at 27-28 weeks, 9.1% at 29-30 weeks, 6.8% at 31-32 weeks and 3.4% at 33-36 weeks. Mortality decreased steadily with increasing gestational age, which was statistically significant (p <0.05). 143 (46.7%) of our patients were male and 163 (53.3%) were female. 29.4% of the patients who died were male and 25.8% were female. When the gender distributions between the patients who died and who survived were compared, no statistically significant difference was observed between the two groups (p=0.603). Chronic lung disease (defined as an oxygen requirement on 28 days of life) developed in 43% of infants. Retinopathy of prematurity (ROP) was noted in 26.7% of infants. Of these infants 11.4% of infants had evidence of necrotizing enterocolitis (NEC). Intraventricular hemorrhage (IVH) was noted in 22.9% of infants. Mortality rate of our neonatal intensive care unit is comparable to other studies around the world. Decline in morbidity and mortality of these newborns (especially the ELBW infants) can only be made possible through optimizing prenatal, natal and postnatal care.