Neonatal morbidity and early outcome of very preterm infants

Background: Although the mortality rate for preterm infants and the gestational age-specific mortality rate have dramatically improved over the last 3 to 4 decades, infants born preterm remain vulnerable to many complications, including respiratory distress syndrome, chronic lung disease, necrotizin...

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Main Authors: Heljić Suada, Terzić Sabina, Spahović Raho, Maksić Hajrija
Format: Article
Language:English
Published: Association of medical doctors Sanamed Novi Pazar 2013-03-01
Series:Sanamed
Subjects:
Online Access:http://sanamed.rs/sanamed_pdf/sanamed_8_1/NEONATAL_MORIDITY.pdf
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author Heljić Suada
Terzić Sabina
Spahović Raho
Maksić Hajrija
author_facet Heljić Suada
Terzić Sabina
Spahović Raho
Maksić Hajrija
author_sort Heljić Suada
collection DOAJ
description Background: Although the mortality rate for preterm infants and the gestational age-specific mortality rate have dramatically improved over the last 3 to 4 decades, infants born preterm remain vulnerable to many complications, including respiratory distress syndrome, chronic lung disease, necrotizing enterocolitis, a compromised immune system, cardiovascular disorders, hearing and vision problems, and brain lesions. The aim is to determine mortality and morbidity rates and selected outcome variables for preterm infant’s <30 weeks’ gestation, who were admitted to the NICU. Patients and methods: This study enrolled 102 infants with gestational age less than 30 weeks’ gestation, hospitalized in Neonatal Intensive Care Unit, Pediatric Hospital, Clinical University Center Sarajevo, from Jan. 2010 to Dec. 2010. Parameters taken at admission were: birth weight, gestational age, Apgar score, excess base and CRIB score. Early outcome is considered as a survival at discharge or common preterm morbidities presented during hospitalization Results: The mean BW of evaluated preterm infants was 1086 ±250 g, the mean GA27.89± 1.97, Apgar score 5.41 ± 1.76, excess base at admission 6.39 ± ± 1.74 and mean CRIB score 3.72 ± 3.16. The overall survival rate was 70.5%. Selected outcomes at discharge were: RDS with 70.5% infants treated with natural surfactant, PDA treated with NSAIDS (23.5%), brain injury (> grade 3 IVH or PVL) 16.6%, NEC Bell stages II or III 9.8%, BPD 25/72 (33.3%) of infants who survived to 36 weeks postmenstrual age. In 38 (37.2%) infants, episodes of infections were noticed (one or more episodes in 25 infants), half of them were caused by Gram positive bacteria, most frequent coagulasa negative staphylococci. Klebsiella pneumoniae was the most frequent organism among Gram negative bacteria. One patient had invasive candidiasis caused by Candida albicans. In 5 infants (4.9%) early onset of sepsis was documented. Conclusion: Very preterm infants remain very vulnerable group of population, and interventions to reduce the morbidity and mortality of preterm babies include tertiary interventions such as regionalized care, transportation in uterus, and treatment with antenatal steroids.
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spelling doaj.art-48f083464a1c40379ba8677a1ca650ec2024-03-02T19:22:13ZengAssociation of medical doctors Sanamed Novi PazarSanamed1452-662X2217-81712013-03-01811923Neonatal morbidity and early outcome of very preterm infantsHeljić Suada0Terzić Sabina1Spahović Raho2Maksić Hajrija3Clinical University Center Sarajevo, Pediatric Hospital, Neonatal Intensive Care Unit, Bosnia and Herzegovina + Faculty of Medicine, University of Sarajevo, Bosnia and HerzegovinaClinical University Center Sarajevo, Pediatric Hospital, Neonatal Intensive Care Unit, Bosnia and Herzegovina + Faculty of Medicine, University of Sarajevo, Bosnia and HerzegovinaClinical University Center Sarajevo, Pediatric Hospital, Neonatal Intensive Care Unit, Bosnia and HerzegovinaClinical University Center Sarajevo, Pediatric Hospital, Neonatal Intensive Care Unit, Bosnia and Herzegovina + Faculty of Medicine, University of Sarajevo, Bosnia and HerzegovinaBackground: Although the mortality rate for preterm infants and the gestational age-specific mortality rate have dramatically improved over the last 3 to 4 decades, infants born preterm remain vulnerable to many complications, including respiratory distress syndrome, chronic lung disease, necrotizing enterocolitis, a compromised immune system, cardiovascular disorders, hearing and vision problems, and brain lesions. The aim is to determine mortality and morbidity rates and selected outcome variables for preterm infant’s <30 weeks’ gestation, who were admitted to the NICU. Patients and methods: This study enrolled 102 infants with gestational age less than 30 weeks’ gestation, hospitalized in Neonatal Intensive Care Unit, Pediatric Hospital, Clinical University Center Sarajevo, from Jan. 2010 to Dec. 2010. Parameters taken at admission were: birth weight, gestational age, Apgar score, excess base and CRIB score. Early outcome is considered as a survival at discharge or common preterm morbidities presented during hospitalization Results: The mean BW of evaluated preterm infants was 1086 ±250 g, the mean GA27.89± 1.97, Apgar score 5.41 ± 1.76, excess base at admission 6.39 ± ± 1.74 and mean CRIB score 3.72 ± 3.16. The overall survival rate was 70.5%. Selected outcomes at discharge were: RDS with 70.5% infants treated with natural surfactant, PDA treated with NSAIDS (23.5%), brain injury (> grade 3 IVH or PVL) 16.6%, NEC Bell stages II or III 9.8%, BPD 25/72 (33.3%) of infants who survived to 36 weeks postmenstrual age. In 38 (37.2%) infants, episodes of infections were noticed (one or more episodes in 25 infants), half of them were caused by Gram positive bacteria, most frequent coagulasa negative staphylococci. Klebsiella pneumoniae was the most frequent organism among Gram negative bacteria. One patient had invasive candidiasis caused by Candida albicans. In 5 infants (4.9%) early onset of sepsis was documented. Conclusion: Very preterm infants remain very vulnerable group of population, and interventions to reduce the morbidity and mortality of preterm babies include tertiary interventions such as regionalized care, transportation in uterus, and treatment with antenatal steroids.http://sanamed.rs/sanamed_pdf/sanamed_8_1/NEONATAL_MORIDITY.pdfvery preterm infantsmortality ratemorbidity rate
spellingShingle Heljić Suada
Terzić Sabina
Spahović Raho
Maksić Hajrija
Neonatal morbidity and early outcome of very preterm infants
Sanamed
very preterm infants
mortality rate
morbidity rate
title Neonatal morbidity and early outcome of very preterm infants
title_full Neonatal morbidity and early outcome of very preterm infants
title_fullStr Neonatal morbidity and early outcome of very preterm infants
title_full_unstemmed Neonatal morbidity and early outcome of very preterm infants
title_short Neonatal morbidity and early outcome of very preterm infants
title_sort neonatal morbidity and early outcome of very preterm infants
topic very preterm infants
mortality rate
morbidity rate
url http://sanamed.rs/sanamed_pdf/sanamed_8_1/NEONATAL_MORIDITY.pdf
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AT terzicsabina neonatalmorbidityandearlyoutcomeofverypreterminfants
AT spahovicraho neonatalmorbidityandearlyoutcomeofverypreterminfants
AT maksichajrija neonatalmorbidityandearlyoutcomeofverypreterminfants