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CC BY 4.0 · Journal of Child Science 2020; 10(01): e32-e37
DOI: 10.1055/s-0040-1713659
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Can Early Clinical Status Predict Outcomes in Extremely Low Birth Weight Neonates?

Alok Kumar MK 
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Femitha Pournami 
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Sujith Kumar Reddy Gurram Venkata
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Anand Nandakumar
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Jyothi Prabhakar
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Naveen Jain
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
› Author Affiliations Funding None.
Further Information

Publication History

27 March 2020

05 May 2020

Publication Date:
26 June 2020 (online)

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Abstract

Background Extremely low birth weight (ELBW) neonates are the sickest patrons of neonatal intensive care. Authors have attempted to predict outcomes based on perinatal factors very soon after birth. Allowing a longer duration for clinical assessment may permit meaningful assessments. Postponing these predictions to several weeks does not offer succour.

Methods We retrospectively studied association of predefined perinatal factors and clinical status of 53 ELBW infants in the first 72 hours of life; with death or continued need for respiratory support at 4 weeks of life separately (RS4).

Results Mean and standard deviations of birth weight and gestational age were 781.8 (±130.7) g (range: 510–990 g) and 26.4 (±1.5) weeks (range: 24–30 weeks), respectively; 32.9% were < 750 g at birth. Of the 53 neonates, 20.7% babies expired and 47.1% required RS4 (66% neonates suffered composite outcome of death/RS4). Need for > 0.3 fraction of inspired oxygen (FiO2) beyond 72 hours of life demonstrated strong association with death/RS4 (odds ratio [OR] 14.3; 95% confidence interval [CI] 3.2–63.0). Need for chest compression (OR 15.3; 95% CI 1.4–167.2) and shock (OR 14.2; 95% CI 2.7–72.8) were significantly associated with mortality.

Conclusion FiO2 requirement of > 0.3 at 72 hours reasonably predicts death or dependence on respiratory supports at 4 weeks of life.

Keywords

extremely low birth weight - infant - extremely premature - patient relevant outcome - bronchopulmonary dysplasia - mortality
 

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