Neonatologic Complications And Long-Term Sequelae Of Extremely Low Birthweight (Elbw) Infants: The Graz Experience

Purpose: To describe neonatologic complications in and longterm sequelae of extremely low birth weight (ELBW) infants.Material and Methods: From 1992 and 1994 82 infants were born between 24 and 27 weeks of gestation or with a birth weight less than or equal to 900 g. Perinatal mortality, neonatal complications and physical and neurological status at age 2-4 years were assessed.Results: The mean (+/- SD) gestational age was 26.3 +/- 1.4 weeks, the mean birth weight was 900 +/- 207 g. The overall perinatal mortality was 27/82 (33%). 13 of these infants (16%) died prenatally and 14/82 (17%) died in the neonatal period. Among 64 vaiable infants the neonatal mortality was 11/64 (17%) and decreased from 4/7 (57 %) at 24 weeks to 2/22 (9 %) at 27 weeks. Survival rates correlated significantly (p = 0.03) with gestational age but not with birth weight. Causes of death were cerebral haemorrhage (5/64, 8%), extreme prematurity (4/64, 6%) or sepsis (2/64, 3%). 31/64 infants (48%) had respiratory distress syndrome with a mean duration of assisted ventilation of 21+/-12 days. 24/64 infants (38%) had intraventricular bleeding and 25 (39%) had signs of bacterial infection. The mean hospital stay was 94 +/- 30 days. At age 2-4 years 26/51 infants were developed appropriately for age. 12/51 (24%) had severe, 3/51 (6%) moderate and 10/51 mild impairment. The incidence of impairment was not associated with gestational age and not higher in infants < 750 g than in those > 750 g.Conclusion: In our series the neonatal mortality rate of ELBW infants was associated with gestational age but not birthweight. The risk of neonatal mortality declined with increasing gestational age but the risk of permanent impairment was associated with neither gestational age nor birthweight.