THE INFLUENCE OF PERINATAL EVENTS ON THE NEONATAL OUTCOME OF THE EXTREMELY LOW BIRTH WEIGHT (ELBW) INFANT. 1602:

We examined the perinatal events of 99 consecutive, live born ELBW infants(BW 762 +/- 143gms, GA 25.6 +/- 2.2wks) in 1993 and 1994 to assess the relationship between perinatal management and neonatal outcome. Survivors consisted of 76 infants. Significant differences between surviving and nonsurviving infants included birth weight (798.2 +/- 130g vs 643.3 +/- 117g, p<0.001), gestational age (26wks +/- 2 vs 24 +/- 2wks, p<0.001), Apgar score at 1 min (5 +/- 2 vs 3 +/- 2 p<0.001), Apgar score at 5 min (7 +/- 2 vs 5 +/- 3, p<0.001), and female sex (56% vs 23%, p<0.006). Using ANOVA, we noted the following antenatal factors to be associated with survival; cesarean section (p<0.02), betamethasone (p<0.002), magnesium sulfate (p<0.02) and tocolysis (p<0.001). Only delivery mode was associated with specific neonatal morbidity: Infants delivered by cesarean section had a lower incidence of intraventricular hemorrhage than those delivered by the vaginal route (25% vs 56%, p<0.005). In this population of ELBW infants, biologic imperatives of BW, GA, and sex and methods of perinatal care significantly affected survival.