IMPROVED OUTCOME INTO THE 1990S FOR INFANTS WEIGHING 500-999 G AT BIRTH

Aims-To compare the survival and sensorineural disability rates in ext remely low birthweight (ELBW) (500-999 g) infants born in 1991-2 with ELBW babies born in 1979-80 and 1985-7, and with normal birthweight in fants born in the same time periods. Methods-ELBW infants born in Vict oria in 1991-2 were compared with regional cohorts of ELBW infants bor n in 1979-80 and 1985-7, and with contemporaneous normal birthweight ( >2499 g) controls, and those of birthweight 500-749 g with those of bi rthweight 750-999 g. Results-In 1979-80, 25.4% (89/351) ELBW live birt hs survived to 2 years of age, increasing significantly to 37.9% (212/ 560) in 1985-7, and to 56.2% (241/429) in 1991-2. The rates of severe disability in survivors assessed were 12.4%, 6.6%, and 6.8% in the 197 9-50, 1985-7, and 1991-2 ELBW cohorts, respectively. The rate of disab ility, overall, was significantly lower in the 1985-7 and 1991-2 ELBW cohorts compared with the 1979-50 ELBW cohort, but was significantly h igher in 1991-2 ELBW infants than normal birthweight controls. Survivi ng children with birthweights <750 g had significantly higher rates of sensorineural disability compared with those of birthweight 750-999 g in 1979-50, but not in 1985-7 or 1991-2. Conclusions-Survival rates f or ELBW babies in Victoria have progressively improved since the late 1970s. Sensorineural outcome for survivors born in 1985-7 has also imp roved compared with those born in 1979-80. However, there is no eviden ce that further reductions in adverse sensorineural outcomes into the 1990s, and these, as well as disabilities remain higher in ELBW than i n normal birthweight babies.