Risk Factors for Neonatal Mortality Among Very Low Birth Weight Neonates

  • Fatemeh Nayeri Neonatologist, Maternal-Fetal-Neonatal Research Center ,Tehran University of Medical Sciences, Tehran, Iran.
  • Hosein Dalili Neonatologist, Breastfeeding Research Center ,Tehran University of Medical Sciences, Tehran, Iran.
  • Firoozeh Nili Neonatologist, Maternal-Fetal-Neonatal Research Center ,Tehran University of Medical Sciences, Tehran, Iran.
  • Elaheh Amini Neonatologist, Breastfeeding Research Center ,Tehran University of Medical Sciences, Tehran, Iran.
  • Ali Ardehali General Physician, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Babak Khoshkrood Mansoori General Physician, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Mamak Shariat Maternal & Child Health Specialist, Maternal-Fetal-Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Keywords:
Neonatal mortality rate (NMR), Risk factor, Very low birth weight (VLBW)

Abstract

The objective of this study is to determine risk factors causing increase in very low birth way (VLBW) neonatal mortality. The medical files of all neonates weighing ≤1500 g, born in Vali-e-Asr hospital (2001-2004) were studied. Two groups of neonates (living and dead) were compared up to the time of hospital discharge or death. A total of 317 neonates were enrolled. A meaningful relationship existed between occurrence of death and low gestational age (P=0.02), low birth weight, lower than 1000 g (P=0.001), Apgar score <6 at 5th minutes (P=0.001), resuscitation at birth (P=0.001), respiratory distress syndrome (P=0.001) need for mechanical ventilation (P=0.001), neurological complications (P=0.001) and intraventricular hemorrhage (P=0.001). Regression analysis indicated that each 250 g weight increase up to 1250 g had protective effect, and reduced mortality rate. The causes of death of those neonates weighting over 1250 g should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 g. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage.

References

Bacak SJ, B apti ste- Roberts K, Amon E, Ireland B, LeetT. Risk factors for neonatal mortality among extremelylow- birth-weight infants. Am J Obstet Gynecol.2005;102:862-7.

Clarence W, Gowen JR. Fetal and neonatal medicine. Kliegman RM, marcdante KJ, Jepson HB, Behrman RE. Nelson essential of pediatrics. 5 th ed. Philadelphia: Elsevier Saunders; 2006; P:275.

Bodeau-Livinec F, Briand V, Berger J, Xiong X, Massougbodji A, Day KP, Cot M. Maternal anemia in benin:prevalence, risk factors, and association with lowbirth weight. Am. J. Trop Med Hyg 2011;85(3):414-20.

Ferraz R, Neves ET. Risk factors for low birth weight in public maternities:a cross-sectional study. Rev Gaucha Enferm 2011;32(1):86-92.

Skilton MR, Viikari JS, Juonala M, Laitinen T, Lehtimäki T, Taittonen L, Kähönen M, Celermajer DS, Raitakari OT. Fetal Growth and Preterm Birth influence Cardiovascular Risk Factors and Arteril Haelth in Young Adults: The Cardiovascular Risk in Young Finns Study. Arterioscler Thromb Vasc Biol 2011;31(12):2975-81.

Iams JD, mercer BM, national Institute of child health and Human Development maternalFetal medicine units network. What we have learned about antenatal prediction of neonatal morbidity and mortality. Semin Perinatal 2003;27(3):247-52.

Gäddlin PO, Finnström O, Sydsjö G, Leijon I.Most very low birth weight subjects do well as adults. Acta Paediatr 2009;98(9):1513-20.

Aarnoudse-Moens CS, Weisglas-Kuperus N, van Goudoever JB, Oosterlaan J. Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children. Pediatrics 2009;124(2):717-28.

Datar A, Jacknowitz A.Birth weight effects on children's mental, motor, and physical development:evidence from twins data. Matern Child Health J 2009;13(6):780-94.

Overturf GD, Marcy M. focal bacterial infections in:Rernington JS, kelin OC. Infectious diseases of the fetus and newborn infant. 5th ed. Philadelphia, W.B wonders; 2005 p:1058-63

manzar S. survival pattern among extreme preterm infants. Saudi med J 2000;21(2):168-7.

Cook Rw. Improved outcome for infants at the limits of viability. Fur J pediatr 1996;155(8):665-7.

Chan K, Ohlsson A, Synnes A, Lee DS, Chien Ly, Lee SK. Canadian neonatal network. Survival, morbidity and resource use of infants of 25 weeks' gestational age or less. Am J Obstet Gynecol 2001;185(1):220-6.

Grupo ollaborativo neocosur. Very-low-birth-weight infant outcomes in 11 South American NICU. a perinat 2002;22(1):2-7.

El-metwally D, Vohr B, tucker R. survival and neonatal morbidity at the limits of viability in the mid 1990s:22 to 25 weeks. J Pediatr 2000;137(5):616-22.

Louis Jm, Ehrenberg Hrn, Collin MF, Mereer BM. Perinatal intervention and neonatal outcomes near the limit of viability. Am J Obstet Gynecol 2004;191(4):1398-402.

Lee Sk,Mcmillan DD, Ohlsson A, Pendray M, Synnes A, Whyte R , Ly, sale J. variations in practice and outcomes in the Canadian NICU net work: 1996-1997. pediatrics 2000;106(5):107-9.

Darlow BA, Cust AE, Donoghue DA. Improved outcome for very low birth weight infants: evidence from new Zealand national population based data. Arch Dis child Fetal neonatal Ed 2003;8(1):f 23-8.

Dmnan N, Kurnral A, Gulean H, Ozkan H. outcome of very-low-birth-weight infants in a developing country: a prospective study from the western region of turkey. J maters fetal neonatal med 2003;13(1):54-8.

Tsou KI, Tsao PN. Taiwan infant Development collaborative study group. The morbidity and survival of very-low-birth-weight infests in Taiwan. Acta paediatr Taiwan 2003;44(6):349-55.

Atasay B, Gunlemez A, Unal S, Arsan S, outcomes of very low birth weight infants in a newborn tertiary center in turkey, 1997-2000. lurk J pediatr 2003;45(4):283-9.

Larroque B, Breast G, Kaminski l1, Andre M, Burguet A, Grandjean H, Ledesert B, Leveque C, Maillard F, Matis .I, Rote JC, Truffert Epipage study group. Survival of very preterm infant: Epipage, a popiil;mon base, cohort study. Arch Dis child Fetal neonatal Ed 2004;89(2):F139-44.

Shankaran S, Fanaroff AA, Wright LL, Stevenson DK, Donovan EF, Ehrenkranz RA, Langer JC, Korones SB, Stoll BJ, Tyson JE, Bauer CR, Lemons JA, Oh W, Papile LA. Risk factors for early death among Extremc',v-birthweight infants. Am J Obstet Gynecol 2002;186(4):769-802.

Niswade A, Zodpey SP, Ughade S, Bangdiwala SI. Neonatal Morbidity and Mortality in tribal and rural communities in central India. Indian J Community Med 2011;36(2):150-8.

Sass A, Gravena AA, Pelloso SM, Marcon SS. Perinatal outcomes in the extremes of reproductive age and factors associated with low birth weight at birth.Rev. Gaucha Enferm 2011;32(2):352-8.

How to Cite
1.
Nayeri F, Dalili H, Nili F, Amini E, Ardehali A, Khoshkrood Mansoori B, Shariat M. Risk Factors for Neonatal Mortality Among Very Low Birth Weight Neonates. Acta Med Iran. 51(5):297-302.
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