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Very preterm birth–a regional study. Part 2: The very preterm infant

  1. R. Hagan Neonatal Paediatrician1,*,
  2. H. Benninger Neonatal Follow-up Co-ordinator1,
  3. D. Chiffings Home Visiting Co-ordinator1,
  4. S. Evans Biostatistician2,
  5. N. French Neonatal Paediatrician1

Article first published online: 19 AUG 2005

DOI: 10.1111/j.1471-0528.1996.tb09712.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 103, Issue 3, pages 239–245, March 1996

Additional Information

How to Cite

Hagan, R., Benninger, H., Chiffings, D., Evans, S. and French, N. (1996), Very preterm birth–a regional study. Part 2: The very preterm infant. BJOG: An International Journal of Obstetrics & Gynaecology, 103: 239–245. doi: 10.1111/j.1471-0528.1996.tb09712.x

Author Information

  1. 1

    Department of Newborn Services, King Edward Memorial Hospital for Women, Subiaco, Australia

  2. 2

    Foundation for Women and Infant's Health, Subiaco, Australia

*Correspondence: Dr R. Hagan, Department of Newborn Services, King Edward Memorial Hospital for Women, 374, Bagot Road, Subiaco, Western Australia 6008, Australia.

Publication History

  1. Issue published online: 19 AUG 2005
  2. Article first published online: 19 AUG 2005
  3. Received 10 October 1994 Returned to author for revision 18 January 1995 & 1 June 1995 Final revised version received 18 June 1995 Accepted 9 August 1995

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Objective To ascertain the growth characteristics, delivery room management and hospital mortality of very preterm live born infants (< 33 weeks of gestation) and to identify differences between infants associated with the aetiological factor related to their very preterm delivery.

Design Cohort analytical study.

Setting King Edward Memorial Hospital for Women, Western Australia.

Main variables examined Gestational age, birthweight, birthweight ratio, condition at birth and mortality.

Results Six hundred and ninety-three live born very preterm infants were born to 608 mothers between 1.1.90 and 31.12.91. This was 1.37% of all live borns in Western Australia. Three hundred and eighty-five (55.6%) were male. Growth characteristics (birthweight, birthweight ratio and proportion small for gestational age) differed between infants depending on the primary obstetric complication associated with the very preterm delivery. Overall 217 (31%) infants were small for gestational age, 34 (4.9%) had a congenital anomaly, and 102 (14.7%) died. Corrected mortality, excluding major fatal congenital anomaly, was 86 (12.7%). The majority of infants died on the first day (n= 59 (57.8%). The only factors associated with an increased or decreased mortality were decreasing gestation (adjusted odds ratio (AOR) 1.7, 95% CI 1.50–1.93), decreasing birthweight ratio (small for gestational age) (AOR 1.3, 95% CI 1.08–1.53), antepartum haemorrhage as primary complication (AOR 3.1, 95% CI 1.25–7.69) and any antenatal steroids (AOR 0.26, 95% CI 0.14–0.51). In comparison with other studies, survival in the extremely preterm group, defined as a gestational age of less than 28 weeks, is improving.

Conclusions Very preterm infants account for a large proportion of perinatal mortality. Further studies are required to explore the differences between infants on the basis of the primary obstetric complication and to ensure that increased survival is not associated with an increase in disabilities.

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