Incidence and survival of very low birth weight infants in a level-II-health care facility

This prospective study was undertaken during July 1990 - July 1991 to determine the incidence of very low birth weight [VLBW] deliveries, and neonatal mortality in this group of infants [birth weight < 1500 g] in Taif Maternity Hospital, a level II health care facility. There were 8895 live births in the hospital during the study period, of which 127 [1.4%] belonged to the VLBW category. Overall, 73 [57%] of these 127 VLBW infants survived beyond the neonatal period. Predictably, there was a direct relationship between survival rate and birth weight. The survival rate was 18% in infants with birth weight between 500 - 750g and 45%, 51% and 73% in those with birth weights of 751 - 1000, 1001 - 1250, and 1251 - 1500 g respectively. Respiratory distress syndrome [50%], birth asphyxia [22%], sepsis [17%] and major congenital malformations [11%] were the main causes of death in the 54 infants who succumbed in the neonatal period. Forty-five [83%] of the 54 deaths occurred in the first week of life, and extremely low birth weight [ELBW] infants [birth weight < 1000 g] accounted for 50% of the total early neonatal mortality. The survival figures for the VLBW infants in this study compare favourably with the published figures from other level II care facilities, but fall slightly short of the figures reported from tertiary level health institutions within and outside the Kingdom. The results, therefore, argue in favour of centralizing the care of high risk neonates in appropriately staffed and well equipped regional centres