Favorable Results of Neonatal Intensive Care for Very Low-Birth-Weight Infants

Abstract

From 1961 to 1976, 229 infants with birth weights ranging from 751 to 1000 g were admitted to the Stanford University Hospital [California, USA] Intensive Care Nursery. The overall neonatal mortality for these infants was 63% (144/229) and there were 10 late deaths. Before 1967 no infant in this group who required mechanical ventilation survived; thereafter, 30% (34/114) of the ventilated patients survived. Of the 75 long-term survivors, 60 participated in a high-risk infant follow-up program; these included 23 infants who had received mechanical ventilation. The mean birth weight of these infants was 928 .+-. 67 (SD) g. Seventeen children (28%) had significant morbidity: 7 (12%) with severe handicaps and 10 (17%) with moderate handicaps. During this same period, 7 infants weighing < 750 g at birth were also observed. The 3 infants who did not require ventilatory support thrived; the other 4 infants required respirators and were significantly handicapped. More recently, neonatal mortality for infants with birth weights from 751-1000 g has improved: for 1977-1980, it was 28% (33/118). Neonatal mortality for ventilated infants in this weight group was 27% (26/95). These data indicate an improved prognosis for very low-birth-weight infants, even with ventilatory support.