Pre-discharge Outcomes of Very Preterm and Very Low Birth Weight Infants from a Tertiary Care Neonatal Center in India.

Abstract

Objectives: This study reports pre-discharge survival and clinical outcomes of very preterm infants (VPI) and very low birth weight (VLBW) infants from a tertiary-care, inborn neonatal unit in India.

Methods: In this retrospective study, inborn neonates admitted between 2013 and 2022 over a 10-y period were included. VLBW group included infants with birth weight (BW) of 500-1499 g with GA ≥26 wk and VPI group included infants with 26^⁰/₇-31^⁶/₇ wk gestational age (GA). Infants with major congenital anomalies, inborn errors of metabolism, or those transferred to another hospital before completion of treatment were excluded.

Results: A total of 2063 VLBW infants and 1663 VPI were analyzed. In the VLBW group, the mean GA and birth weight were 30.4 wk and 1173 g, respectively. Survival was 90.6% among VLBW infants and 76.9% among extremely low birth weight infants. Major morbidities included late-onset culture-positive sepsis (LOS: 18.1%), intraventricular hemorrhage (IVH) ≥ Grade II (7.1%), and retinopathy of prematurity (ROP) requiring treatment (2.2%). In the VPI group, mean GA and birth weight were 30.0 wk and 1180 g. Survival rates were 89.1% for VPI and 66.8% for the extremely preterm subgroup. Rates of LOS, IVH ≥ Grade II, ROP requiring treatment, and bronchopulmonary dysplasia in VPI were 20.9%, 8.8%, 2.5%, and 2.9%, respectively.

Conclusions: Very preterm and VLBW infants demonstrated high survival with low rates of major morbidities. However, improvement in survival at lower gestational ages remains a key area for improvement.