Trends in short-term outcomes of very low birth weight infants from a single center in Shanghai from 2013 to 2023

Abstract

Background: Very low birth weight infants (VLBWI) are vulnerable to serious complications. We aim to describe the short-term outcomes of VLBWI in a single center during 2013-2023, providing the basis for clinical disease management.

Methods: A retrospective study of VLBWI admitted to a tertiary neonatal intensive care unit (NICU) between 1 January 2013 and 31 December 2023 was conducted to analyze trends of mortality and major morbidities over the 11-year period. Infants were divided into two subgroups according to birth weight (BW): <1,000 and 1,000-1,500 g. Major morbidities were defined as bronchopulmonary dysplasia (BPD), late onset sepsis (LOS), intraventricular hemorrhage (IVH) ≥ grade 3, necrotizing enterocolitis (NEC) ≥ stage 2, retinopathy of prematurity (ROP) ≥ stage 3 or needed treatment, and periventricular leukomalacia (PVL).

Results: A total of 2,475 VLBWI were enrolled from 2013 to 2023. Analysis showed that the overall trend of mortality, LOS, NEC, IVH and PVL decreased, but BPD and ROP increased during the 11 years. Except for ROP, which exhibited a consistent increasing trend, other outcomes have a significant inflection point. Mortality, LOS, NEC, IVH and PVL kept steady initially, but decreased quickly around 2017. BPD was stable from 2013 to 2016, after which it increased dramatically. Most trends in the two subgroups by BW were similar to the patterns in the overall infants.

Conclusions: Mortality and most morbidities in VLBWI decreased from 2013 to 2023, with the exception of BPD and ROP. Continuous research and quality improvement (QI) efforts should be made to further improve the outcomes of VLBWI, especially for BPD and ROP.

Keywords: Trends; morbidity; mortality; premature; very low birth weights (VLBW).

Figure 1

Short-term outcomes trend among VLBWI from 2013 to 2023. The graph illustrates the observed rate trends (solid line) with 95% confidence interval (dotted line) for mortality and major morbidities. BPD, bronchopulmonary dysplasia; IVH, intraventricular hemorrhage; LOS, late-onset sepsis; NEC, necrotizing enterocolitis; PVL, periventricular leukomalacia; ROP, retinopathy of prematurity; VLBWI, very low birth weight infants.