Mortality and morbidity of neonates born at < 26 weeks of gestation (1998-2003). A population-based study

Objective: To describe mortality and morbidity of neonates born at <26 weeks' gestation in a contemporary population-based cohort. Methods: We analyzed data of neonates born at <26 weeks between 1998 and 2003 in the Federal State of Hesse, Germany. Survival was calculated at 28 days and at discharge from hospital. Results: Out of a total of 800 births, 572 infants were liveborn. Among those admitted for neonatal intensive care, 62.3% survived until day 28. Among the neonates followed until death or discharge, 59.6% were discharged home. Logistic regression analyses showed the following variables to be associated with an increased risk of death: Twins (Odds Ratio (OR) 3.7; 95% Confidence Interval (CI) 1.34-10.26), multiple birth >= 3 (OR 8.14; CI 1.23-53.86), intraventricular hemorrhage (IVH) >= grade III (OR 4.79; CI 1.89-12.14), clinical risk index for babies score > 15 (OR 2.9; CI 1.09-7.76), and a gestational age <= 23 weeks (OR 5.34; CI 1.24-22.98). Among infants discharged home, bronchopulmonary dysplasia was diagnosed in 52.2%, IVH >= grade III and/or periventricular leukomalacia in 15%, and severe retinopathy of prematurity in 29.8%. Conclusions: This study provides outcome data derived from a contemporary population-based cohort. Mortality and complication rates remain high.