PC.06 Outcome of infants with birth weight less than 500 grams in a tertiary neonatal unit

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Abstract

Background

Advances in obstetric and neonatal practice have potentially increased survival at the limits of viability and in severely growth restricted infants. In the UK, the proportion of liveborn infants weighing <500 g increased from 0.1 to 0.2% between 2004 and 2010.1,2

Aim

To provide short-term morbidity and mortality data for infants weighing <500 g from one tertiary neonatal unit.

Methods

Infants with birth weight <500g admitted between January 2004 and December 2013 identified, notes reviewed and outcomes quantified.

Results

There were 26 admissions with birth weight <500 g over the ten year period. Outborn infants and those with major congenital anomaly were excluded (n = 4). Gestational age ranged from 22+3 to 28+2 weeks and birth weight from 358 to 495 g. 91% received antenatal steroids, 73% were delivered by caesarean section and 100% received surfactant. There are two groups of infants: appropriately grown (n = 9) and severely growth restricted (n = 13).

Results

14 of 22 infants survived to discharge (64%). Of the surviving infants, 93% were receiving breast milk at full feeds, 21% had intraventricular haemorrhage (IVH) (maximum grade 2) and 86% required home oxygen. Of the infants who died, two had grade 3 or 4 IVH and two had necrotising enterocolitis.

Conclusion

Infants with birth weight <500 g are a rarely reported group. This case series reports 64% survival, in contrast to 18% from Europe1 and 20% from the USA.3 These outcome data highlight increasing ethical dilemmas in the management of this group.

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