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Infants Born Weighing <400 g Who Survive at Risk for Severe Morbidity

One in five infants born at <400 g survives, but neurodevelopmental impairment common

WEDNESDAY, March 27, 2019 (HealthDay News) — One-fifth of infants born with a birth weight (BW) less than 400 g survive to 18 to 26 months’ corrected age, but they are at high risk for neurodevelopmental impairment, according to a study published online March 25 in JAMA Pediatrics.

Jane E. Brumbaugh, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues used data from the National Institute of Child Health and Human Development Neonatal Research Network to retrospectively review outcomes of 205 liveborn infants with a BW <400 g and a gestational age of 22 to 26 weeks. Neurodevelopmental outcomes were assessed for infants who survived to 18 to 26 months' corrected age and returned for a comprehensive visit.

The researchers found that 49.3 percent of the infants received active treatment at birth, and of these infants, 25.7 percent survived to discharge. Of the 36 actively treated infants with a BW <400 g and a gestational age of 22 to 23 weeks, six survived to discharge. Among infants born between 2008 and 2015, 26 percent of the actively treated infants survived to discharge. In addition, two infants died after discharge and two were lost to follow-up, leading to 19 of 90 actively treated infants able to be evaluated at 18 to 26 months' corrected age. Moderate or severe neurodevelopmental impairment was seen in 74 percent of these infants.

“Although 21 percent of infants survived to 18 to 26 months’ corrected age with active treatment, neurodevelopmental impairment was common among survivors,” the authors write.

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