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Archivos de Pediatría del Uruguay

versão impressa ISSN 0004-0584


COSTAS, MARIELA; DOMINGUEZ, SUSANA; GIAMBRUNO, GONZALO  e  MARTELL, MIGUEL. Morbimortalidad y crecimiento de los niños con muy bajo peso al nacer hospitalizados. Arch. Pediatr. Urug. [online]. 2005, vol.76, n.4, pp. 289-304. ISSN 0004-0584.

Background: due to the combined efforts of obstetricians and neonatologists in optimizing perinatal and neonatal care, survival of infants with extremely low birth weight (ELBW) has improved remarkably in the last decade. However, improved survival of premature infants has been accompanied by increasing recognition of log-term neurological deficits, chronic lung complications and other morbidities. Objective: to evaluate the mortality, morbidity and growth in weight of infants with ELBW in two level III neonatal intensive care units (NICUs). Methods: a 3-year retrospective review of 130 infant’s £ 1500 g birth weights who were admitted in two level III neonatal intensive care units (Hospital de Clinics and AEPSM). Results: of 130 infants, 106 (82%) were discharged from the hospital. The survival rates for all infants admitted to a NICU were, respectively, 0% for £ 23 weeks, 43% for 24 weeks, 83% for 25 weeks, 70% for 26 weeks, 80% for 27 weeks, 93% for 28 weeks, 81% for 29 weeks and 100% for ³ 30 weeks. 78% of the infants received treatment with surfactant, 28% have chronic lung disease, 26% late sepsis, 22% patent ducts arteriosus, 10% retinopathy of prematurity, 3% intraventricular hemorrhage grade III-IV, and 1% necrotizing enterocolitis. 100% of the infants with  26 weeks have some morbidity, however only 10% of the infants with = 30 weeks have some morbidity. Most ELBW infants did nor achieve catch-up growth during the neonatal intensive care unit hospitalization when compared with the median birth weight of a reference fetus of the same postmenstrual age. Average daily weight gain (g/kg body weight/d) after regaining birth weight was similar to the reported intrauterine weight gain. The factor significantly associated with a higher growth velocity was a caloric intake = 100 to 125 cal/Kg/d. Conclusions: the mortality and morbidity decreased dramatically with the increment of the gestational age. The morbidity most significative was chronic lung disease and their pathology associated: the late sepsis. Studies using calories closer to the upper ranges of the recommendations and designed to reduce the incidence of/or severity of chronic lung disease need to be conducted in the extremely premature population.


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