Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction☆,☆☆
Section snippets
Methods
We examined the morbidity and mortality associated with IUGR within the Vermont Oxford Network database.15 Neonates with birth weights between 501 and 1500 g are enrolled in the database if they are either born at a participating institution or transferred there within 28 days of birth. This database enrolled 49,335 neonates between 1991 and 1996 at 212 participating institutions. Additional details regarding this database have been previously published.15 Entries to the database are screened
Results
Nine percent (n = 1720) of the infants in the study population were found to have IUGR according to the modified US Center for Health Statistics natality database. Ten percent of the neonates enrolled for this project died before discharge. Ninety-four percent of the enrolled infants underwent neonatal cranial ultrasonographic examinations, and the incidence of intraventricular hemorrhage was 28%. The incidence of severe intraventricular hemorrhage (intraventricular hemorrhage grade III or IV)
Comment
The specific risk attributable to IUGR in the morbidity of neonates has been difficult to isolate. Data consistently demonstrate an increase in gestational age–corrected mortality rate among infants with IUGR, but morbidity risks have varied widely. One potential explanation for this discrepancy is the degree to which potential confounding variables are accounted for. In an initial report that suggested a protective effect of IUGR against intraventricular hemorrhage and RDS, Procianoy et al2
Acknowledgements
Participating investigators in the Vermont Oxford Network and their institutional affiliations are as follows:
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Huntsville Hospital, Huntsville, AL
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Meyer E. Dworsky, MD, Linda S. Reynolds, RN, BSN
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Providence Alaska Medical Center, Anchorage, AK
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Roy F. Davis, MD, Sharon J. Hulman, RN
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Phoenix Children’s Hospital, Phoenix, AZ
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Michael C. McQueen, MD
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St Joseph’s Hospital & Medical Center, Phoenix, AZ
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Montgomery Hart, MD, Marie King, RN
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California Pacific Medical Center, San Francisco, CA
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Terri A. Slagle, MD,
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Reprint requests: A. Lynn Stillman, Network Administrator, Vermont Oxford Network, 444 S Union St, Burlington, VT 05401.
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0002-9378/2000 $12.00 + 06/1/101977