MORTALITY OF PRETERM INFANTS FROM 1980 TO 1990 - AN ANALYSIS AT A GERMAN PERINATAL CENTER

We analyzed retrospectively (1980-1990) the causes of death and by usi ng a logistic regression model the perinatal and neonatal risk factors influencing the mortality in preterm infants <34 weeks of gestation ( n=1132). When comparing the interval from 1980-1986 to 1987-1990 we ob served a decreasing mortality in infants less than or equal to 1000 g from 57% to 19% as well as in the preterm infants > 1000 g from 8.3% t o 3.0% (p<0.001). The causes of death changed considerably. During 198 0-1986 fifty-two (8.2%) out of the 632 preterm infants and during 1987 -1990 only seven (1.3%) out of the 600 preterm infants died in the cou rse of a severe respiratory distress syndrome or intracranial hemorrha ges. From 1980 to 1986 21% (n=10) and from 1987 to 1990 77% (n=10) of the neonatal deaths in preterm infants > 1000 g were attributed to let hal malformations.In those infants without lethal malformations (n=110 9) we performed a logistic regression analysis. 87 (7.8%) of these neo nates died. The risk of dying was significantly higher in infants barn before 1987, in male newborns and in infants suffered from a severe r espiratory distress syndrome III degrees-IV degrees or septicemia (p < 0.0001). An increasing gestational age of one week resulted in a lowe red risk of mortality (odds ratio 0.59, p < 0.0001). Adjusted for thes e basic variables the mortality risk was also significantly higher for birth weights less than or equal to 1000 g, low Apgar scores, peripar tal acidosis, hypothermia and intracranial hemorrhages. An intrauterin e growth retardation <10, percentile resulted in a lower mortality ris k.