Skip to main content
American Journal of Public Health logoLink to American Journal of Public Health
. 1995 Mar;85(3):362–366. doi: 10.2105/ajph.85.3.362

Obstetrical judgments of viability and perinatal survival of extremely low birthweight infants.

M L Reuss 1, H R Gordon 1
PMCID: PMC1614864  PMID: 7892920

Abstract

OBJECTIVES. The purpose of the study was to determine whether the obstetrical judgment of viability makes a difference to fetal and neonatal survival of extremely low birthweight infants (500-749 g). METHODS. We assessed the effect of the antenatal judgment of viability in a group of 66 infants born weighing from 500 to 749 g. These infants were alive at maternal hospital admission and were subsequently live-born or stillborn between January 1, 1984, and December 31, 1985. We related the antepartum assessment of viability and other factors recorded in the medical record to fetal survival and to postneonatal survival to hospital discharge. RESULTS. The obstetrical judgement of viability was strongly associated with outcome. After birthweight and gestational age were controlled, fetuses considered viable were 18 times more likely to survive (95% confidence interval = 2, 175) than those considered nonviable. CONCLUSIONS. The effects of obstetrical practices on perinatal mortality must be taken into consideration in estimating the survival potential of very small fetuses and in evaluating the relationship between survival and disability.

Full text

PDF
362

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen M. C., Donohue P. K., Dusman A. E. The limit of viability--neonatal outcome of infants born at 22 to 25 weeks' gestation. N Engl J Med. 1993 Nov 25;329(22):1597–1601. doi: 10.1056/NEJM199311253292201. [DOI] [PubMed] [Google Scholar]
  2. Arnold C. C., Kramer M. S., Hobbs C. A., McLean F. H., Usher R. H. Very low birth weight: a problematic cohort for epidemiologic studies of very small or immature neonates. Am J Epidemiol. 1991 Sep 15;134(6):604–613. doi: 10.1093/oxfordjournals.aje.a116133. [DOI] [PubMed] [Google Scholar]
  3. Delaney-Black V., Lubchenco L. O., Butterfield L. J., Goldson E., Koops B. L., Lazotte D. C. Outcome of very-low-birth-weight infants: are populations of neonates inherently different after antenatal versus neonatal referral? Am J Obstet Gynecol. 1989 Mar;160(3):545–552. doi: 10.1016/s0002-9378(89)80023-7. [DOI] [PubMed] [Google Scholar]
  4. Fenton A. C., Field D. J., Mason E., Clarke M. Attitudes to viability of preterm infants and their effect on figures for perinatal mortality. BMJ. 1990 Feb 17;300(6722):434–436. doi: 10.1136/bmj.300.6722.434. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Kiely J. L., Paneth N., Susser M. Fetal death during labor: an epidemiologic indicator of level of obstetric care. Am J Obstet Gynecol. 1985 Dec 1;153(7):721–727. doi: 10.1016/0002-9378(85)90331-x. [DOI] [PubMed] [Google Scholar]
  6. Lubchenco L. O., Butterfield L. J., Delaney-Black V., Goldson E., Koops B. L., Lazotte D. C. Outcome of very-low-birth-weight infants: does antepartum versus neonatal referral have a better impact on mortality, morbidity, or long-term outcome? Am J Obstet Gynecol. 1989 Mar;160(3):539–545. doi: 10.1016/s0002-9378(89)80022-5. [DOI] [PubMed] [Google Scholar]
  7. Lubchenco L. O., Butterfield L. J., Delaney-Black V., Goldson E., Koops B. L., Lazotte D. C. Outcome of very-low-birth-weight infants: does antepartum versus neonatal referral have a better impact on mortality, morbidity, or long-term outcome? Am J Obstet Gynecol. 1989 Mar;160(3):539–545. doi: 10.1016/s0002-9378(89)80022-5. [DOI] [PubMed] [Google Scholar]
  8. Paul R. H., Koh K. S., Monfared A. H. Obstetric factors influencing outcome in infants weighing from 1,001 to 1,500 grams. Am J Obstet Gynecol. 1979 Mar 1;133(5):503–508. doi: 10.1016/0002-9378(79)90284-9. [DOI] [PubMed] [Google Scholar]
  9. Shamsi H. H., Petrie R. H., Steer C. M. Changing obstetric practices and amelioration of perinatal outcome in a university hospital. Am J Obstet Gynecol. 1979 Apr 15;133(8):855–858. doi: 10.1016/0002-9378(79)90301-6. [DOI] [PubMed] [Google Scholar]
  10. Silver R. K., MacGregor S. N., Farrell E. E., Ragin A., Davis C., Socol M. L. Perinatal factors influencing survival at twenty-four weeks' gestation. Am J Obstet Gynecol. 1993 Jun;168(6 Pt 1):1724–1731. doi: 10.1016/0002-9378(93)90683-a. [DOI] [PubMed] [Google Scholar]
  11. Whyte H. E., Fitzhardinge P. M., Shennan A. T., Lennox K., Smith L., Lacy J. Extreme immaturity: outcome of 568 pregnancies of 23-26 weeks' gestation. Obstet Gynecol. 1993 Jul;82(1):1–7. [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES