ORIGINAL ARTICLE

¹ Department of Paediatrics, Christchurch School of Medicine, Christchurch, New Zealand
² Centre for Perinatal Health Services Research, University of Sydney, Sydney, NSW 2006, Australia

Correspondence to:
Correspondence to:
Professor Darlow, Department of Paediatrics, Christchurch School of Medicine, PO Box 4345, Christchurch, New Zealand:
brian.darlow{at}chmeds.ac.nz

Objective: To compare the survival and short term morbidity of all New Zealand very low birthweight (VLBW) infants born in two epochs, 1986 and 1998–1999.

Setting: All level III and level II neonatal intensive care units (NICUs) in New Zealand.

Methods: In 1986, data were prospectively collected for a study of retinopathy of prematurity (ROP). In 1998–1999, prospective data were collected by the Australian and New Zealand Neonatal Network (ANZNN). Both cohorts included all VLBW infants born during the calendar year and admitted to a NICU. Data were collected from birth until discharge home or death.

Results: More VLBW infants were admitted for care in 1998–1999 (n = 1084, 0.96% of livebirths) than in 1986 (n = 413, 0.78% of livebirths; p < 0.001), including a higher proportion of VLBW infants of < 1000 g birth weight (38% v 32% respectively; p < 0.05). Survival to discharge home increased from 81.8% in 1986 to 90.3% in 1998–1999 (p < 0.001). The 1998–1999 cohort had a higher proportion of infants born in a hospital with a level III NICU (87% v 72% in 1986; p < 0.001) and receiving antenatal corticosteroids (80% v 58% in 1986; p < 0.001). In 1998–1999, the incidence of several morbidities had decreased compared with 1986, including oxygen dependency at 28 days (29% v 39% respectively; p = 0.001) and at 36 weeks postmenstrual age (16% v 23%; p = 0.002), grade 1 intraventricular haemorrhage (IVH) (8% v 24%; p < 0.001), grade 2/3 IVH (5% v 11%; p < 0.001), and stage 3/4 ROP for infants < 1000 g (6% v 13%; p < 0.001).

Conclusions: The outlook for VLBW infants in New Zealand has improved since 1986.

Keywords: very low birthweight infant; premature; diseases; intensive care

Abbreviations: ANZNN, Australian and New Zealand Neonatal Network; VLBW, very low birthweight; NICU, neonatal intensive care unit; CLD, chronic lung disease; PMA, postmenstrual age; ROP, retinopathy of prematurity; IPPV, intermittent positive pressure ventilation; CPAP, continuous positive airways pressure; IVH, intraventricular haemorrhage; GA, gestation; HMD, hyaline membrane disease

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Fantoms

Martin Ward Platt
Arch. Dis. Child. Fetal Neonatal Ed. 2003 88: F2. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Dhaliwal, C, Fleck, B, Wright, E, Graham, C, McIntosh, N (2008). Incidence of retinopathy of prematurity in Lothian, Scotland, from 1990 to 2004. Arch. Dis. Child. Fetal Neonatal Ed. 93: F422-F426 [Abstract] [Full Text]  
• Zeitlin, J., Draper, E. S., Kollee, L., Milligan, D., Boerch, K., Agostino, R., Gortner, L., Van Reempts, P., Chabernaud, J.-L., Gadzinowski, J., Breart, G., Papiernik, E., and the MOSAIC research group, (2008). Differences in Rates and Short-term Outcome of Live Births Before 32 Weeks of Gestation in Europe in 2003: Results From the MOSAIC Cohort. Pediatrics 121: e936-e944 [Abstract] [Full Text]  
• Doyle, L. W., Faber, B., Callanan, C., Freezer, N., Ford, G. W., Davis, N. M. (2006). Bronchopulmonary Dysplasia in Very Low Birth Weight Subjects and Lung Function in Late Adolescence. Pediatrics 118: 108-113 [Abstract] [Full Text]  
• Henderson-Smart, D J, Hutchinson, J L, Donoghue, D A, Evans, N J, Simpson, J M, Wright, I, for the Australian and New Zealand Neonatal Networ, (2006). Prenatal predictors of chronic lung disease in very preterm infants. Arch. Dis. Child. Fetal Neonatal Ed. 91: F40-F45 [Abstract] [Full Text]  
• Mikkola, K., Ritari, N., Tommiska, V., Salokorpi, T., Lehtonen, L., Tammela, O., Paakkonen, L., Olsen, P., Korkman, M., Fellman, V., for the Finnish ELBW Cohort Study Group, (2005). Neurodevelopmental Outcome at 5 Years of Age of a National Cohort of Extremely Low Birth Weight Infants Who Were Born in 1996-1997. Pediatrics 116: 1391-1400 [Abstract] [Full Text]  
• Ho, S., Saigal, S. (2005). Current Survival and Early Outcomes of Infants of Borderline Viability. NeoReviews 6: e123-e132 [Full Text]  
• Schulenburg, W E, Tsanaktsidis, G (2004). Variations in the morphology of retinopathy of prematurity in extremely low birthweight infants. Br. J. Ophthalmol. 88: 1500-1503 [Abstract] [Full Text]  
• Bhutta, Z. A, Khan, I., Salat, S., Raza, F., Ara, H. (2004). Reducing length of stay in hospital for very low birthweight infants by involving mothers in a stepdown unit: an experience from Karachi (Pakistan). BMJ 329: 1151-1155 [Abstract] [Full Text]