Survival of Very Low Birth Weight Infants in Neonatal Intensive Care Unit at the Mahdieh Hospital (Tehran-Iran)

Very low birth weight (VLBW) infants (4-7% live birth) are at high risk for mortality (one third of neonatal mortality). To determine the frequency of disease-free survival, complications and risk factors for morbidity and mortality in VLBW neonates. This cross-sectional retrospective study was performed from April 2007 to March 2010 on all hospitalized VLBW neonates in neonatal intensive care unit (NICU) at the Mahdieh hospital in Tehran, Iran. Relevant pre- and peri-natal data up to the time of discharge from the hospital or death, including complications during the course of hospitalization, were collected and compared. Five hundred and sixty four neonates were included in the study during three years. Overall survival was 70.9%; in ELBW newborns this figure was 33.3% rising to 84.1% in infants weighing between 1001-1500 grams. Mean gestational age was 29.6 ± 2.5 weeks, mean birth weight was 1179 ± 258 grams and Mean hospitalization duration was 29.7 ± 23.6. Mean birth weight, gestational age and APGAR scores were significantly higher in babies who survived than those who died, (1275 ± 189 vs. 944 ± 253 grams; 30.5 ± 2.2 vs. 27.5 ± 2 weeks and 6.9 ± 1.7 vs. 5 ± 2.1 respectively; p <0.001 in all instances) but needs for CPR was more in dead newborns (p<0.001). Need for mechanical ventilation, pulmonary hemorrhage and gastro-intestinal bleeding were also significant predictive factors for mortality. Although our survival was compatible with most of developing countries but for improving survival, especially in ELBW suggest increasing the quality of prenatal care, regionalization, standard CPR in delivery room and improving the quality of care in NICU.