Poster session V Clinical obstetrics, epidemiology, infectious disease, intrapartum fetal, operative obstetrics, medical-surgical-diseases-complications, obstetric quality and safety, public health/global health: Abstracts 687 - 836| Volume 208, ISSUE 1, SUPPLEMENT , S317-S318, January 01, 2013

756: Compared mortality and morbidity of preterm low birthweight infants born between 1995-2010: a population based study


      To assess the changes in neonatal mortality and morbidity of VLBW infants born 1995-2010.

      Study Design

      Population based observational study of the Israel Neonatal Network on VLBW (≤1500 g) 24-31 weeks live-born. Definitions:Vermont Oxford Trials Network. Mortality: death at any time before discharge. Morbidity: early &late sepsis, RDS, BPD, ROP 3&4, IVH 3&4, PVL,NEC. To analyze the impact of time on the outcomes the cohort was divided into three groups, for equal time frames (5 years each). Statistics: chi2, Mantel-Haenszel, univariate&multivariable logistic regression.


      10,705 VLBW: 3846(1995-2000), 3475 (2001-2005), 3384 (2006-2010):total neonatal mortality decreased significantly (p<0.0001) : OR 1; 0.78 ( 0.67-0.90); 0.72 (0.62-0.84) respectively. The significant lower threshold of this improvement pattern was BW <500 & GA 25wks, and lost significance >31 weeks. All severe morbidities decreased significantly (Table). A significant increase in maternal age (p=0.0001),high education (+13 y) p=<0.0001, antenatal care started <12 weeks (72.6% women to 82.0%) (p<0.0001) and fertility therapy (p=0.0003) occured. Hypertension and antepartum bleeding showed no change, while GDM increased (p=0.005). Interestingly, significant decrease in premature labor (p<0.0001), PPROM (p<0.0001) and chorioamnionitis (p<0.0001) observed. The cesarean raised significantly (60.8% to 67.9%) (P<0.0001); with no significant change in GA at birth (28.3+/−2.3) and its distribution, BW, gender and SGA. However, there was a significant decrease in delivery room resuscitation (p<0.0001) and 5'Apgar <7 (p=0.0006).
      Tabled 1Multivariable analysis of infant morbidities by time intervals (5 years each)
      Table thumbnail grr57


      The comparison of VLBW infants outcomes born five years apart showed a significant decrease of mortality and morbidity, paralleled by noteworthy changes in the maternal demographic characteristics. This analysis emphasizes the need to continuously follow and update neonatal outcomes. The provision of an appropriate estimate of neonatal risks is mandatory in counseling families.