Major anomalies and birth-weight influence NICU interventions and mortality in infants with trisomy 13 or 18

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Abstract

OBJECTIVE:

To describe neonatal intensive care unit (NICU) medical interventions and NICU mortality by birth weight and major anomaly types for infants with trisomy 13 (T13) or 18 (T18).

STUDY DESIGN:

Retrospective cohort analysis of infants with T13 or T18 from 2005 to 2012 in the Pediatrix Medical Group. We classified infants into three groups by associated anomaly type: neonatal surgical, non-neonatal surgical and minor. Outcomes were NICU medical interventions and mortality.

RESULTS:

841 infants were included from 186 NICUs. NICU mortality varied widely by anomaly type and birth weight, from 70% of infants <1500 g with neonatal surgical anomalies to 31% of infants > 2500 g with minor anomalies. Infants ≥ 1500 g without a neonatal surgical anomaly comprised 66% of infants admitted to the NICU; they had the lowest rates of NICU medical interventions and NICU mortality.

CONCLUSIONS:

Risk stratification by anomaly type and birth weight may help provide more accurate family counseling for infants with T13 and T18.

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