Resumen

KESHISHIAN, Ruty  y  MARTELL, Miguel. Sobrevida y morbilidad en recién nacidos que pesaron menos de 1.000 gramos. Arch. Pediatr. Urug. [online]. 2008, vol.79, n.3, pp.210-220. ISSN 1688-1249.

Introduction. the survival rate of newborns with gestational age of 28 weeks or less and with a weight lower than 1.000 g has improved,  making necessary a better knowledge about morbidity and mortality. The classification is by weight and gestational age in order to help the obstetric decisions and the information given to parents. Objective: to describe life expectancy and the most frequent and severe pathologies in these newborns in our country. Methods: this is an observational descriptive and retrospective study in which 123 newborns weighing less than 1.000 g were evaluated in a 5 year period. Group 1 was conformed by 13 newborns with 29 weeks of gestational age at birth or more, all of them being small for the gestational age (score "z" between -2, 1 and -2, 4). Group 2 was constituted by 110 preterm newborns less than 29 weeks of gestational age, adequate for gestational age when analyzed by weight at birth. A description of the most frequent complications and the survival of these children is presented. The definition of bronchopulmonary dysplasia (BPD)applied was the persistent requirement of oxygen at 36 weeks of age. Results. group 1 survival was 100% and the group 2 survival was 63%. In the last group the most frequent complication was BPD which appeared in 77%; 39% was mild and 27% had moderate or severe forms. A significant relationship between the mechanical ventilation period and the development of this pathology was found. Newborns who had less weight and lower gestational age required more time of mechanical ventilation. The first extubation failed in 58% of the patients, however the ventilation parameters required after the first extubation were no different from those of the last 24 h of ventilation. In those newborns which could not be weaned from ventilator, corticoids were administered in 54% of patients decreasing the FiO₂ in 30% and the airway medium pressure in 2 cm H₂O after 48 h. The weaning process was favored in 50% of patients. If corticoid administration was required after a free interval the result was the same. The frequency of complications was compared with updated literature showing severe intraventricular hemorrhage is less than the media, sepsis the same as the media and all the other complications over this point (near 75%). Conclusion. almost all complications were associated to BPD, and this pathology is in relationship with the prolongation of mechanical ventilation. It is necessary to improve the  respiratory aspects related to ventilation and weaning in order to prevent the clinical deterioration which requires reintubation

Palabras clave : INFANT, VERY LOW BIRTH WEIGHT; MORBIDITY;  BRONCHOPULMONARY DYSPLASIA; ADRENAL CORTEX HORMONES-therapeutic use; SURVIVORSHIP.

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