Trends in Perinatal Practices and Neonatal Outcomes of VLBW Infants during a 16-year Period at NEOCOSUR Centers

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We examined data for 13,987 VLBW infants with mean BW 1,081±281 g and GA 28.8±2.9 weeks. Overall mortality was 26.8% without significant changes throughout the study period. Reductions in early-onset sepsis from 6.3% to 2.8% (P < .001); late-onset sepsis from 21.1% to 19.5% (p = 0.002); retinopathy of prematurity from 21.3% to 13.8% (p<0.001); and hydrocephalus from 3.8% to 2.4% (p<0.001), were observed. The incidence for bronchopulmonary dysplasia decreased from 17.3% to 16% (p=0.043); incidence for severe intraventricular hemorrhage was 10.4%, necrotizing enterocolitis 11.1%, and periventricular leukomalacia 3.8% and did not change over the study period. Administration of antenatal corticosteroids increased from 70.2% to 82.3% and cesarean delivery from 65.9 to 75.4% (p <0.001). The use of conventional mechanical ventilation decreased from 67.7% to 63.9% (p <0.001) and CPAP increased from 41.3% to 64.3 % (p <0.001). Survival without major morbidity increased from 37.4% to 44.5% over the study period (p<0.001).

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