Volume 11, Issue 12 (1-2013)                   IJRM 2013, 11(12): 957-0 | Back to browse issues page

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Haghighi L, Nojomi M, Mohabbatian B, Najmi Z. Survival predictors of preterm neonates: Hospital based study in Iran (2010-2011). IJRM 2013; 11 (12) :957-0
URL: http://ijrm.ir/article-1-379-en.html
1- Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran
2- Department of Community Medicine, School of Medicine Iran University of Medical Sciences, Tehran, Iran
3- Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran , zahranaj@student.tums.ac.ir
Abstract:   (2647 Views)
Background: Preterm birth (PTB) is responsible for 70% of neonatal mortalities. Various factors influence the risk of neonatal mortality in different populations.
Objective: Our objective was to evaluate neonatal survival rate of preterm infants, and to define its predictors in Iranian population.
Materials and Methods: This retrospective cohort study included all preterm (26-37 weeks) infants (n=1612) born alive in Shahid Akbar-abadi university hospital, during one year period (April 2010-2011). These infants were evaluated for fetal-neonatal, maternal, and pregnancy data. Survival analysis was performed and viability threshold and risk factors of neonatal mortality were evaluated.
Results: Total overall mortality rate was 9.1%. Survival rate were 11.11% for extremely low birth weights (LBW) and 45.12% for very early PTBs. The smallest surviving infant was a 750 gr female with gestational age (GA) of 30 weeks and the youngest infants was a 970 gram female with GA of 25weeks plus 2 days. History of previous dead neonate, need to cardio-pulmonary resuscitation (CPR), need to neonatal intensive care unit (NICU) admission, postnatal administration of surfactant, presence of anomalies, Apgar score <7, multiple pregnancy, non-cephalic presentation, early PTB, very early PTB, LBW, very low birth weight (VLBW) and extremely low birth weight (ELBW), were risk factors for mortality in preterm neonates.
Conclusion: Our study revealed that neonatal survival rate is dramatically influenced by birth weight especially under 1000grams, GA especially below 30 weeks, neonatal anomalies, history of previous dead fetus, multiple pregnancy, non- cephalic presentation, and need for NICU admission, resuscitation and respiratory support with surfactant
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Type of Study: Original Article |

References
1. Khashu M, Narayanan M, Bhargava S, Osiovich H. Perinatal outcomes associated with preterm birth at 33 to 36 weeks' gestation: a population-based cohort study. Pediatrics 2009; 123: 109-113. [DOI:10.1542/peds.2007-3743]
2. Institute of Medicine. Preterm Birth: Causes, Consequences, and Prevention. Brief report. Washington DC, Institute of Medicine; 2006.
3. Keshtkaran A, Keshtkaran V. Factors affecting neonatal death in Fars Province, Southern Iran, 2004. Midd East J Family Med 2007; 5: 42-45.
4. Wen SW, Smith G, Yang Q, Walker M. Epidemiology of preterm birth and neonatal outcome. Semin Fetal Neonatal Med 2004; 9: 429-435. [DOI:10.1016/j.siny.2004.04.002]
5. Repka MX. Ophthalmological problems of the premature infant. Ment Retard Dev Disabil Res Rev 2002; 8: 249-257. [DOI:10.1002/mrdd.10045]
6. Golestan M, Fallah R, Akhavan Karbasi S. Neonatal mortality of low birth weight infants in Yazd, Iran. Iran J Reprod Med 2008; 6: 205-208. [DOI:10.1016/j.earlhumdev.2008.09.065]
7. Amon E. Limits of fetal viability. Obstetric considerations regarding the management and delivery of the extremely premature baby. Obstet Gynecol Clin North Am 1988; 15: 321-338.
8. Hack M, Fanaroff AA. Outcomes of children of extremely low birth weight and gestational age in the 1990s. Semin Neonatol 2000; 5: 89-106. [DOI:10.1053/siny.1999.0001]
9. Parappil H, Rahman S, Salama H, Al Rifai H, Parambil NK, El Ansari W. Outcomes of 28+1 to 32+0 weeks gestation babies in the state of Qatar: finding facility-based cost effective options for improving the survival of preterm neonates in low income countries. Int J Environ Res Public Health 2010; 7: 2526-2542. [DOI:10.3390/ijerph7062526]
10. Lackman F, Capewell V, Richardson B, daSilva O, Gagnon R. The risks of spontaneous preterm delivery and perinatal mortality in relation to size at birth according to fetal versus neonatal growth standards. Am J Obstet Gynecol 2001; 184: 946-953. [DOI:10.1067/mob.2001.111719]
11. Kimberlin DF, Hauth JC, Owen J, Bottoms SF, Iams JD, Mercer BM, et al. Indicated versus spontaneous preterm delivery: An evaluation of neonatal morbidity among infants weighing DOI:10.1016/S0002-9378(99)70273-5]
12. Markestad T, Kaaresen PI, Rønnestad A, Reigstad H, Lossius K, Medbø S, et al. Norwegian Extreme Prematurity Study Group. Early death, morbidity, and need of treatment among extremely premature infants. Pediatrics 2005; 115: 1289-1298. [DOI:10.1542/peds.2004-1482]
13. Shah V, Alwassia H, Shah K, Yoon W, Shah P. Neonatal outcomes among multiple births ≤32 weeks gestational age: does mode of conception have an impact? A cohort study. BMC Pediatr 2011; 11: 54. [DOI:10.1186/1471-2431-11-54]
14. Rüegger C, Hegglin M, Adams M, Bucher HU. Swiss Neonatal Network. Population based trends in mortality, morbidity and treatment for very preterm-and very low birth weight infants over 12 years. BMC Pediatr 2012; 12: 17. [DOI:10.1186/1471-2431-12-17]
15. Rojas-Reyes MX, Morley CJ, Soll R. Prophylactic versus selective use of surfactant in preventing morbidity and mortality in preterm infants. Cochrane Database Syst Rev 2012; 3: CD000510. [DOI:10.1002/14651858.CD000510.pub2]
16. Pulver LS, Guest-Warnick G, Stoddard GJ, Byington CL, Young PC. Weight for gestational age affects the mortality of late preterm infants. Pediatrics 2009; 123: 1072-1077. [DOI:10.1542/peds.2008-3288]
17. Fallahian M, Mohammad K, Aghaie E, Ghandi A. Mortality rate of preterm neonates in two teaching hospitals in Tehran, Islamic Republic of Iran. East Med Health J 1995; 1: 201-204.
18. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams obstetrics. 23rd Ed. McGrow-Hill, USA; 2010: 806.
19. Vazirinejad, R; Masoodpour, N; Puyanfar. Survival Rate of Low and Very Low Birth Weight Neonates in an Iranian Community. Iran J Public Health 2012; 41: 87-93.
20. Navaei F, Aliabady B, Moghtaderi J, Moghtaderi M, Kelishadi R. Early outcome of preterm infants with birth weight of 1500 g or less and gestational age of 30 weeks or less in Isfahan city, Iran. World J Pediatr 2010; 6: 228-232. [DOI:10.1007/s12519-010-0204-1]
21. Kent AL, Wright IM, Abdel-Latif ME; New South Wales and Australian Capital Territory Neonatal Intensive Care Units Audit Group. Mortality and adverse neurologic outcomes are greater in preterm male infants. Pediatrics 2012; 129: 124-131. [DOI:10.1542/peds.2011-1578]
22. Swenson AW, Dechert RE, Schumacher RE, Attar MA. The effect of late preterm birth on mortality of infants with major congenital heart defects. J Perinatol 2012; 32: 51-54. [DOI:10.1038/jp.2011.50]
23. Malloy MH. Impact of cesarean section on neonatal mortality rates among very preterm infants in the United States, 2000-2003. Pediatrics 2008; 122: 285-292. [DOI:10.1542/peds.2007-2620]
24. Reddy UM, Zhang J, Sun L, Chen Z, Raju TN, Laughon SK. Neonatal mortality by attempted route of delivery in early preterm birth. Am J Obstet Gynecol 2012; 207: 117. [DOI:10.1016/j.ajog.2012.06.023]
25. Demirci O, Tugrul AS, Turgut A, Ceylan S, Eren S. Pregnancy outcomes by mode of delivery among breech births. Arch Gynecol Obstet 2012; 285: 297-303. [DOI:10.1007/s00404-011-1956-0]

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