Outcomes and Management of Fetal Infants with Birth Weight Below 500 g at a Tertiary Center / 소아과

ABSTRACT

PURPOSE: The purpose of this study was to report outcome of fetal infants with birth weight below 500 g known as lower limit of viability and to evaluate treatment characteristics and short-term morbidity of their survivors. METHODS: We retrospectively analyzed the medical records of all fetal infants with birth weight below 500 g who were delivered at Samsung Medical Center (SMC), or transferred to neonatal intensive care unit (NICU) of SMC within 24 hrs after birth between 1994 and 2004. Data for all interventions and morbidity outcome were analyzed for infants who were admitted to the NICU and were compared between NICU survivors and deaths. RESULTS: Among 53 infants with birth weights of 400 to 499 g who were born in SMC during the study period, 8 (15.1%) infants were admitted to the NICU and one was transferred to NICU from other hospital. Overall, 4 (44%) of 9 survived and were discharged from the NICU. The smallest infant who survived weighed 439 grams. The least gestational age was 23 (+3) among the survivors. Compared with NICU deaths, NICU survivors had larger gestational age (24 (+2) +/-1 (+3) vs. 25 (+4) +/-2 (+3) ) and birth weight (424+/-17 vs. 453+/-19) (P< 0.05). Median survival duration of NICU deaths was 15 days. None of NICU survivors had severe IVH, but 3 (75%) had laser therapy for retinopathy of prematurity and bronchopulmonary dysplasia, respectively. CONCLUSION: Fetal infants with birth weight below 500 g known as lower limit of viability survived successfully. Study for their long-term follow-up will be needed to define our limit of viability and indication for their active resuscitation.