Does parity affect the neonatal outcome of very-low-birth-weight infants?

Objective: To evaluate the impact of parity on the neonatal outcome (surviv al, bronchopulmonary dysplasia and severe intraventricular hemorrhage) of v ery-low-birth-weight infants, accounting Tol sociodemographic. obstetric an d perinatal variables. Study design: One hundred and eleven singleton prema ture infants with birth weights of 750-1250 grams, delivered between 1990 a nd 1991 and treated in the Hadassah University Hospitals in Jerusalem, were evaluated. In the analyses, variables with statistically significant assoc iation with the outcome variables were identified and entered together with parity as explanatory variables in a logistic regression. The results were analyzed with and without the inclusion of respiratory distress syndrome. representing an index of initial illness severity, in the multivariate mode l. Results: Neonatal mortality was higher in the 2-11 parity group when com pared with first born infants. This association was of borderline statistic al significance (OR=3.3; P=0.09), and was evident only upon exclusion of re spiratory distress syndrome from the equation. There was no association bet ween parity and the development of bronchopulmonary dysplasia. The risk for developing severe intraventricular hemorrhage was higher in offsprings of multiparous women (OR=4.6; P=0,08 for parity 2-4 and OR=7.6: P=0.03 for par ity 5-11). Respiratory distress syndrome was significantly associated with all the outcome variables and, to some extent, masked the relevance of preg nancy duration. A short hospitalization period before delivery was associat ed with increased mortality and with higher incidence of severe intraventri cular hemorrhage. High initial Apgar scores appeared protective against sev ere err intraventricular hemorrhage and bronchopulmonary dysplasia. Conclus ion. Our results demonstrate a trend for increased survival of first born p remature infants when compared with offsprings of subsequent deliveries. an d an association between advanced parity and the development of severe intr aventricular hemorrhage. Confirmation of these data by other studies is req uired before resultant implications are considered. (C) 2001 Elsevier Scien ce ireland Ltd. All rights reserved.