A retrospective cohort study on mortality, morbidity, and care practices for 1750 very low birth weight infants, 2016–2021

Abstract

Abstract Background: Very low birth weight (VLBW) infants are the key populations in neonatology, wherein morbidity and mortality remain major challenges. Methods: A retrospective cohort study conducted aiming to analyze the clinical characteristics of VLBW in our hospital between January 2016 and December 2021. Neonates with a birth weight of <1500 g were included. Mortality, care practices, and major morbidities were analyzed, and compared with that of previous 7 years (2009–2015). Results: Of the total 1750 VLBW, 1386 infants born with birth weight between 1000–1499 g and 364 were below 1000 g, 42.9% (751/1750) required delivery room resuscitation, 53.9% (943/1750) received non-invasive ventilation only, 38.2% (669/1750) received invasive ventilation; 1517 VLBW infants received complete treatment. Among them, 60.1% (912/1517) of neonates had neonatal respiratory distress syndrome (NRDS), 28.7% (436/1517) had bronchopulmonary dysplasia (BPD), 22.0% (334/1517) had apnea, 11.1% (169/1517) had culture-confirmed sepsis, 8.4% (128/1517) had pulmonary hemorrhage, 7.6% (116/1517) had severe intraventricular hemorrhage (IVH)/periventricular leukomalacia (PVL), 5.7% (87/1517) had necrotizing enterocolitis (NEC), 2.0% (31/1517) had severe retinopathy of prematurity. The total and in-hospital mortality rates were 9.7% (169/1750) and 3.0% (45/1517), respectively. The top three diagnoses of death among those who had received complete treatment were sepsis, NRDS, and NEC. In 2009–2015, 1146 VLBW were enrolled and 895 infants received complete treatment. The incidences of apnea, IVH, and IVH stage ≥3/PVL, were higher in 2009–2015 compared with those in 2016–2021, while the incidences of NRDS and BPD were characterized by significant increases in 2016–2021. The total and in-hospital mortality rates were 16.7% (191/1146) and 5.6% (50/895) respectively in 2009–2015. Conclusion: Among VLBW infants born in 2016–2021, the total and in-hospital mortality rates were lower than those of neonates born in 2009–2015. Incidences of NRDS and BPD increased in 2016–2021, which affected the survival rates and long-term prognosis of VLBW.