Short-term outcome in infants with a birthweight less than 501 grams

Aim: To report survival and morbidity until discharge in preterm infants < 501 g with life support started immediately after birth. Methods/study design: Cohort study of all preterm infants with birthweights < 501 g born in three tertiary perinatal centres between 1 January 1998 and 31 December 2001 (gestational age (GA) 25.2 [21.0-30.7] wk; birthweight 435 [290-500] g; median [range]). Results: A total of 107 infants with birthweights < 501 g were born. Twenty-nine were stillborn. A prenatal decision to initiate life support immediately after birth was reached in 9/37 (24%) infants < 24.0 wk GA and in 39/42 (93%) infants ≥ 24.0 wk GA. Survival was 3/37 (8%) and 26/41 (63%) in infants < 24 wk GA and ≥ 24.0 wk GA, respectively. Twenty-nine of the 48 infants with immediate life support (60%) survived (95% CI: 46-75%). Forty-two of these 48 (88%) infants were small for gestational age. No infant without immediate life support survived (0/30). Twenty-three (79%) survivors developed chronic lung disease (CLD) and eight (28%) received photocoagulation for retinopathy of prematurity (ROP). Conclusion: In this population of extremely low birthweight infants, survival was higher than in previous studies when life support was provided immediately after birth. Short-term morbidity was similar to other studies. The presented data on survival support our concept to offer immediate life support after birth in preterm infants with birthweights < 501 g. The long-term outcome of these infants needs to be assessed urgently.