Changes of Mortality and Morbidity of Very Low Birth Weight Infants after Neonatal Intensive Care Unit Strategy Alteration in a Single Center: Comparison with 2015 Korean Neonatal Network Report.

Jung,  Seung Mi; Seok,  Min Jeong; Chun,  Ji Yong; Sung,  Tae Jung

doi:2018.25.1.29

Neonatal Med > Volume 25(1); 2018 > Article

Original Article

Neonatal Medicine 2018;25(1):29-36.
DOI: https://doi.org/10.5385/nm.2018.25.1.29 Published online February 28, 2018.

Changes of Mortality and Morbidity of Very Low Birth Weight Infants after Neonatal Intensive Care Unit Strategy Alteration in a Single Center: Comparison with 2015 Korean Neonatal Network Report.

Seung Mi Jung, Min Jeong Seok, Ji Yong Chun, Tae Jung Sung

Department of Pediatrics, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea. neosung@hallym.or.kr

Abstract

PURPOSE
The purpose of this study was to investigate the outcome after changes in the treatment strategies for very low birth weight infant (VLBWI) in a single neonatal intensive care unit (NICU) center.
METHODS
We performed a retrospective review of 300 VLBWI born from 1st January 2010 to 31th December 2016. We compared the outcomes including survival rate, birth weight (BW), gestational age (GA), and morbidities between period I (2010–2013, P-I) and period II (2014–2016, P-II).
RESULTS
The average survival rate was not different between P-I and P-II. However, the survival rate of ≤24 weeks' GA, 25 weeks' GA, 26 weeks' GA were 57%, 69%, 93% respectively in P-II and 31%, 59%, 87% in P-I respectively. The survival rate of infants with birth weight <500 g, 500–749 g, 750–999 g were 100%, 55%, 90% respectively in P-II and 50%, 24%, 80%, respectively in P-I. The incidence of bronchopulmonary dysplasia (BPD) was higher in P-II than in P-I (P=0.012) and moderate-to-severe BPD was also higher in P-II (P=0.004). Incidence of patent ductus arteriosus (PDA) with treatment, necrotizing enterocolitis (stage≥2), and abnormal brain sonography were significantly lower in P-II (P=0.027, P=0.032, P=0.005). Incidences of retinopathy of prematurity (ROP) with laser treatment and early sepsis were not different.
CONCLUSION
The survival rate and complications of VLBWI were improved in period II, especially in less than 750 g and below 26 weeks, except incidence of BPD. Changes of NICU strategies were effective to improve mortality and morbidity in VLBWI.

Key Words: Very low birth weight infant; Mortality; Morbidity; Intensive care unit; Complication