Major anomalies and birth-weight influence NICU interventions and mortality in infants with trisomy 13 or 18

J Perinatol. 2017 Apr;37(4):420-426. doi: 10.1038/jp.2016.245. Epub 2017 Jan 12.

Abstract

Objective: To describe neonatal intensive care unit (NICU) medical interventions and NICU mortality by birth weight and major anomaly types for infants with trisomy 13 (T13) or 18 (T18).

Study design: Retrospective cohort analysis of infants with T13 or T18 from 2005 to 2012 in the Pediatrix Medical Group. We classified infants into three groups by associated anomaly type: neonatal surgical, non-neonatal surgical and minor. Outcomes were NICU medical interventions and mortality.

Results: 841 infants were included from 186 NICUs. NICU mortality varied widely by anomaly type and birth weight, from 70% of infants <1500 g with neonatal surgical anomalies to 31% of infants ⩾2500 g with minor anomalies. Infants ⩾1500 g without a neonatal surgical anomaly comprised 66% of infants admitted to the NICU; they had the lowest rates of NICU medical interventions and NICU mortality.

Conclusions: Risk stratification by anomaly type and birth weight may help provide more accurate family counseling for infants with T13 and T18.

Publication types

  • Multicenter Study

MeSH terms

  • Birth Weight*
  • Chromosomes, Human, Pair 13
  • Chromosomes, Human, Pair 18
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Intensive Care Units, Neonatal / statistics & numerical data*
  • Male
  • Respiration, Artificial / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • Trisomy
  • Trisomy 13 Syndrome / mortality*
  • Trisomy 13 Syndrome / therapy
  • Trisomy 18 Syndrome / mortality*
  • Trisomy 18 Syndrome / therapy
  • United States / epidemiology