Survival of low-birth-weight infants at Baragwanath Hospital - 1950-1996

Objectives. To examine changes in survival rates among low-birth-weight (LB W) infants between the years 1950 and 1996. Methods. Survival figures were analysed for LBW infants managed at Baragwan ath Hospital, a tertiary care centre in Soweto, Johannesburg, over four per iods spanning five decades. Results. The overall mortality rates of LBW infants decreased markedly betw een the early 1950s and the period 1995/96, By the mid-1990s approximately four times the number of infants with birth weight less than 1 500 g were s urviving compared with the early 1950s. The reduction in mortality rates oc curred in all LBW groups during the first three decades. However, since 198 1 infants who weighed less than 1 500 g at birth were the major contributor s to the overall reduction in mortality. Between the years 1981/82 and 1995 /96, survival increased significantly from 64% to 79% for infants with birt h weight 1 000 - 1 499 g, and from 14% to 32% for those with birth weight l ess than 1 000 g. Since infants in the latter group were seldom offered mec hanical ventilation or artificial surfactant, a large part of these increas es in survival can be attributed to improvement in the general level of car e. Conclusion. There have been dramatic improvements in the survival of LBW in fants over this time period at Baragwanath Hospital. Although newer interve ntions such as mechanical ventilation and artificial surfactant have played a significant role, improvement in care at primary and secondary levels ha s been of major importance.