Aims:1.To determine the survival and morbidity of infants at discharge with a birthweight of less than 1500 g in the geographically defined population of Ea st Anglia.2.To demonstrate a cost-effective method of region...Aims:1.To determine the survival and morbidity of infants at discharge with a birthweight of less than 1500 g in the geographically defined population of Ea st Anglia.2.To demonstrate a cost-effective method of regional data collectio n.3.To determine whether there were any changes in the demand for neonatal car e.Study design and subjects:A prospective cohort analysis using a single datab ase to collect data on 1244 very low birthweight infants from eight neonatal uni ts in one Region from 1993 to 1997.Results:Estimated ascertainment of VLBW inf ants to the study was 96%.Over the 5 years survival rates were stable(75-79 %).52%of deaths in infants admitted for neonatal care occurred on day 1,with just 15%of deaths occurring after 28 days of life.Mortality risk significantl y decreased with increasing gestational age at birth.Compared to 22-25-week o ld infants,the mortality risk decreased by 65%for 26-27-week old infants(OR 0.35 95%CI(0.21,0.59))and by 92%for 32-39-week old infants(OR 0.08 95% CI(0.03,0.21))with intermediate odds ratios of 0.22(0.12,0.42)and 0.13(0.06,0.28)for the 28-29 and 30-39 weeks gestation,respectively.Higher birthw eight,after adjusting for gestation also decreased the mortality risk(OR 0.78 per 100 g difference,95%CI(0.71,0.86)).No change was seen in the number of extremely preterm infants admitted for intensive care or resource utilisation,a lthough a significant increase was seen in the number of infants dying in delive ry rooms.There was a reduction in the reported incidence of pulmonary interstit ial emphysema(10-4%)but no change in the number of ventilation days or the r ate of chronic lung disease.The mean maternal age increased from 27.7 years to 28.9 years during the study.Maternal steroid administration increased(30%to 5 9%)and was associated with a decreased risk of mortality(OR 0.44,95%CI:0.3 1-0.62).Conclusions:It is possible to collect useful data from the neonatal p eriod at a reasonable cost from a geographically defined population.This inform ationwas used for informing cl展开更多
文摘Aims:1.To determine the survival and morbidity of infants at discharge with a birthweight of less than 1500 g in the geographically defined population of Ea st Anglia.2.To demonstrate a cost-effective method of regional data collectio n.3.To determine whether there were any changes in the demand for neonatal car e.Study design and subjects:A prospective cohort analysis using a single datab ase to collect data on 1244 very low birthweight infants from eight neonatal uni ts in one Region from 1993 to 1997.Results:Estimated ascertainment of VLBW inf ants to the study was 96%.Over the 5 years survival rates were stable(75-79 %).52%of deaths in infants admitted for neonatal care occurred on day 1,with just 15%of deaths occurring after 28 days of life.Mortality risk significantl y decreased with increasing gestational age at birth.Compared to 22-25-week o ld infants,the mortality risk decreased by 65%for 26-27-week old infants(OR 0.35 95%CI(0.21,0.59))and by 92%for 32-39-week old infants(OR 0.08 95% CI(0.03,0.21))with intermediate odds ratios of 0.22(0.12,0.42)and 0.13(0.06,0.28)for the 28-29 and 30-39 weeks gestation,respectively.Higher birthw eight,after adjusting for gestation also decreased the mortality risk(OR 0.78 per 100 g difference,95%CI(0.71,0.86)).No change was seen in the number of extremely preterm infants admitted for intensive care or resource utilisation,a lthough a significant increase was seen in the number of infants dying in delive ry rooms.There was a reduction in the reported incidence of pulmonary interstit ial emphysema(10-4%)but no change in the number of ventilation days or the r ate of chronic lung disease.The mean maternal age increased from 27.7 years to 28.9 years during the study.Maternal steroid administration increased(30%to 5 9%)and was associated with a decreased risk of mortality(OR 0.44,95%CI:0.3 1-0.62).Conclusions:It is possible to collect useful data from the neonatal p eriod at a reasonable cost from a geographically defined population.This inform ationwas used for informing cl
