Postdischarge Infant Mortality Among Very Low Birth Weight Infants: A Population-Based Study

Abstract

OBJECTIVE. The objective of this study was to identify factors that were associated with death after discharge from the NICU of very low birth weight infants in a population-based study. METHODS. From a national cohort of 13430 very low birth weight infants who were born in Israel from 1995 to 2003, 10602 infants were discharged from the hospital and composed the study population. Demographic and clinical data regarding the pregnancy, delivery, and neonatal course were obtained from the Israel national very low birth weight infant database. Data on each case of death during the postdischarge period until 1 year of age were provided by the Ministry of Health from national linked birth and death certificates. Univariate analyses and a multivariable logistic regression analyses were performed to examine the perinatal and neonatal risk factors for postdischarge death. RESULTS. The postdischarge mortality rate was 7.5 per 1000 (80 of 10602 infants discharged from the hospital). The death rate was significantly higher in non-Jewish infants, infants who were born to young mothers, and infants who were born to low-educated mothers. After adjustment for demographic characteristics and perinatal and neonatal variables, postdischarge mortality was independently associated with congenital malformations, neonatal seizures, necrotizing enterocolitis, and bronchopulmonary dysplasia. CONCLUSION. Although the postdischarge death rate was relatively low in our cohort of very low birth weight infants, attention should be focused on the subgroups of infants who are at higher risk to decrease their mortality further.