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Changes in the Outcomes of Very Low Birth Weight Infants

Journal of the Korean Pediatric Society 2002;45(7):828-835.
Published online July 15, 2002.
Changes in the Outcomes of Very Low Birth Weight Infants
Shung Shin Kim1, Moon Hee Kim2, Jae Won Shin2, Sun Young Ko2, Eun Kyung Lee3, Yun Sil Chang2, I Seok Kang2, Won Soon Park2, Mun Hyang Lee2, Sang Il Lee2, Heung Jae Lee2
1Department of Pediatrics, College of Medicine, Soonchunhyang University, Bucheon Hospital, Bucheon, Korea
2Department of Pediatrics, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Korea
3Department of Pediatrics, College of Medicine, Pocheon CHA University, Kangnam CHA General Hospital , Seoul, Korea
신생아 집중치료를 받은 극소저출생체중아치료성적의 시기에 따른 변화
김성신1, 김문희2, 심재원2, 고선영2, 이은경3, 장윤실2, 강이석2, 박원순2, 이문향2, 이상일2, 이흥재2
1순천향대학교 의과대학 부천병원 소아과
2성균관대학교 의과대학 삼성서울병원 소아과
3포천중문의과대학 강남차병원 소아과
Correspondence: 
Won Soon Park, Email: wspark@smc.samsung.co.kr
Abstract
Purpose
: The outcomes of infants weighing less than 1,500 gm(very low birth weight infant : VLBWI) reflect recent progress in neonatal intensive care. In this study, we analyzed changes over time in survival rate and morbidity of VLBWIs during the past seven years.
Methods
: A retrospective review of medical records was analyzed for VLBWIs admitted to the neonatal intensive care unit of Samsung Medical Center within three days from birth. We compared the outcomes of previous corresponding data(period I : Oct. 1994 to Sept. 1996), with the outcomes of period II(Oct. 1996 to Dec. 1998) and period III(Jan. 1999 to Dec. 2000).
Results
: As shown in Tables 1 and 3, the distribution of birth weight, gestational age(GA), gender, and inborn admissions did not change during the 7-year study. The overall survival rate of VLBWI increased significantly over time(period I : 72% vs period III : 88.3%, P<0.05). Between period I and period II, the birth weight-specific survival rate increased by 23.6%(75% vs 92.7%, P<0.05) for infants 1,000 to 1,249 gm. Between period II and period III, the birth weight-specific survival rate increased three times(20% vs 66.7%, P<0.05) for infants <750 gm. The survivors of lowest birth weight included infants at 624 gm(GA : 26+5 weeks), 667 gm(GA : 25+6 weeks) and 480 gm(GA : 26+2 weeks) in each period. The gestational age-specific survival rate in period III increased significantly in GA 25-26 weeks and 29-30 weeks(vs period I & period II, P<0.05). The survivors of lowest gestational age included infants at GA 26 weeks(970 gm), GA 23+5 weeks(791 gm) and GA 24+1 weeks(740 gm) in each period. The incidence of severe IVH(grade III, IV) and the early death rate(Conclusion
: The survival rate of VLBWI continues to increase, particularly for BW <750 gm, GA <26 weeks. This increase in survival is not associated by any increase in major morbidities.
Key Words: Very Low birth weight infant, Intensive care, Outcome


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