Major birth defects in very low birth weight infants in the Vermont OxfordNetwork

Objective: To studs, the frequency and hypes of major birth defects in very low birth weight (VLBW) infants and their impact on mortality and resource use. Study design: Analysis of data from the Vermont Oxford Network Database fro m 1994 and 1995 on infants with birth weights of 501 to 1500 g. Major birth defects were reported from a list of 40 defined major defects or if they w ere considered lethal or life-threatening. Mortality and length of stay wer e determined. Results: Major birth defects were present in 823 (4.3%) of 19,228 VLBW infa nts from 147 hospitals. The most common categories were chromosomal anomali es (20%); named syndromes, sequences, and associations ( 19%; and gastroint estinal (14%), cardio-vascular (11%) and nervous system (10%) anomalies. In fants with major birth defects had a higher mortality rate (58% vs 13%, P < .001) and a higher rate or major surgery (29% vs 5%, P < .001) than infant s without such defects. Infants with major birth defects accounted for 16.3 % of deaths and 18.9% of major surgical procedures but only for 2.9% of tot al hospital clays. Conclusions: Major birth defects accounted for 16% of all deaths in VLBW in fants. However, they accounted for a low proportion or total hospital da,ys .