Major birth defects in very low birth weight infants in the Vermont Oxford Network.

Abstract

To study the frequency and types of major birth defects in very low birth weight (VLBW) infants and their impact on mortality and resource use. Analysis of data from the Vermont Oxford Network Database from 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 were considered lethal or life-threatening. Mortality and length of stay were determined. Major birth defects were present in 823 (4.3%) of 19,228 VLBW infants from 147 hospitals. The most common categories were chromosomal anomalies (20%); named syndromes, sequences, and associations (19%); and gastrointestinal (14%), cardiovascular (11%), and nervous system (10%) anomalies. Infants with major birth defects had a higher mortality rate (58% vs 13%, P <.001) and a higher rate of major surgery (29% vs 5%, P <.001) than infants 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 total hospital days. Major birth defects accounted for 16% of all deaths in VLBW infants. However, they accounted for a low proportion of total hospital days.