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Evaluation of Perinatal and Management Factors Associated with Improved Survival in Extremely Low Birth Weight Infants

Korean Journal of Pediatrics 2005;48(12):1324-1329.
Published online December 15, 2005.
Evaluation of Perinatal and Management Factors Associated with Improved Survival in Extremely Low Birth Weight Infants
Sung Eun Park1, Ga Won Jeon1, Chang Won Choi2, Jong Hee Hwang3, Soo Hyun Koo1, Yu Jin Kim1, Chang Hoon Lee1, Yun Sil Chang1, Won Soon Park1
1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
2Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam
3Department of Pediatrics, Ilsan Paik Hospital, Inje University School of Medicine, Koyang, Korea
출생 체중 1,000 g 미만의 초극소 미숙아의 생존율 향상과 연관된 산과 및 치료인자
박성은1, 전가원1, 최장원2, 황종희3, 구수현1, 김유진1, 이장훈1, 장윤실1, 박원순1
1성균관대학교 의과대학 삼성서울병원 소아과
2분당 서울대학교병원 소아과
3인제대학교 의과대학 일산백병원 소아과
Correspondence: 
Won Soon Park, Email: wspark@smc.samsung.co.kr
Abstract
Purpose
: The aim of this study was to evaluate recent improvements in the survival rate of extremely low birth weight (ELBW) infants and to identify perinatal and management factors that are associated with improved survival.
Methods
: Two groups of ELBW infants who were admitted to our neonatal intensive care unit (NICU) during two distinct eras : November 1994-December 1999 (Period 1 : n=100) and January 2000-April 2004 (Period 2 : n=166) were retrospectively reviewed.
Results
: Despite the younger gestational age and smaller birth weight of the ELBW infants in period 2, not only did their survival rate increased to 75 percent from 60 percent in period 1, but their incidence of morbidities such as bronchopulmonary dysplasia, confimed sepsis and intraventricular hemorrhage (≥Grade III) also declined. Factors significantly associated with improved survival included the use of antenatal steroids, a longer duration of nasal continuous positive airway pressure and the absence of intraventricular hemorrhage (≥Grade III).
Conclusion
: We believe that optimized clinical practice, that emphasized less invasive care, contributed to the recent improvements in the survival rate of ELBW infants.
Key Words: Extremely low birth weight , Survival , Morbidity , Prematurity


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