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 2010.1,2Aim
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.