Short-term outcome of mechanically ventilated infants weighing more than 2499 g at birth: a population based study

J Paediatr Child Health. 1993 Dec;29(6):418-23. doi: 10.1111/j.1440-1754.1993.tb03012.x.


Very little data exist describing the neonatal outcome of infants of birthweight 2500 g or more who require mechanical ventilation. Our aim was to collect population-based data on such infants in New South Wales (NSW), and to monitor their neonatal morbidity, mortality to 1 year of age and the associated risk factors. The study group (NICUS infants) comprised all 341 infants weighing > 2499 g who were admitted to the seven neonatal intensive care units in New South Wales and mechanically ventilated for 4 h or more between 1 January and 31 December, 1987. Two groups of infants emerged: those who were preterm and mostly had hyaline membrane disease, and term and post-term infants for whom the most common problem was 'perinatal asphyxia'. The most important factors associated with dying were a birthweight of over 3499 g (OR = 2.6; CI 1.03-6.6) and a 1 min Apgar score < 4 (OR = 4.8; CI 1.4-16.9). Study group mothers were significantly more likely than all NSW mothers to have had a spontaneous abortion in the previous pregnancy (P < 0.01), a pre-existing medical condition or an obstetric complication in this pregnancy, or a Caesarean section for this delivery (P < 0.001). This is the first population-based study of high-risk neonates without congenital anomalies to clearly document the worsening prognosis associated with a birthweight over 3499 g. Further research should be directed towards identifying prenatal and perinatal factors which might minimize the morbidity and mortality in this group of babies.

Publication types

  • Multicenter Study

MeSH terms

  • Apgar Score
  • Asphyxia Neonatorum / epidemiology
  • Asphyxia Neonatorum / mortality
  • Asphyxia Neonatorum / therapy
  • Birth Weight
  • Fetal Macrosomia / mortality
  • Humans
  • Hyaline Membrane Disease / mortality
  • Hyaline Membrane Disease / therapy
  • Infant, Newborn
  • Infant, Newborn, Diseases / mortality*
  • Infant, Newborn, Diseases / therapy
  • Infant, Premature
  • Logistic Models
  • Morbidity
  • Prospective Studies
  • Respiration, Artificial*
  • Risk Factors
  • Seizures / epidemiology