Preterm born babies with extremely low birth weight have an increased risk of death during the first year of life, and despite of extensive studies of risk factors that potentially contribute to the death of preterm infants, there is only limited information available once infants are released from the neonatal intensive care unit (NICU). A new study in The Journal of Pediatrics shows that African-Americans stay longer in the NICU, whilst poorer access to healthcare can increase the mortality risk after discharge from the NICU.

Lilia C. De Jesus, MD, from Wayne State University and team, retrospectively evaluated 5,364 preterm babies of 27 weeks’ gestational age or less, with extremely low birth weights of 1000 g or less who were born from 2000 to 2007 at Eunice Kennedy Shriver Neonatal Research Network sites. Researchers followed up with these infants from NICU discharge until they reached a corrected age of 18-22 months.

From a total of successfully followed up 4,807 infants, 107 died following discharge from the NICU, i.e. 22.3 per 1000 extremely low birth weight infants. The researchers observed that the likelihood of dying after NICU discharge was double in African-American infants, compared with other racial groups.

The chances of infant mortality was also observed to be 3-times higher in infants who were in the NICU for 120 days or longer, and 15-times higher if the maternal insurance status was unknown, compared with private insurance, which could suggest poorer access to healthcare. Furthermore, the researchers noted that maternal exposure to antibiotics during pregnancy lowered the risk of infant mortality.

According to The World Factbook, the United States’ infant mortality ranks 48th worldwide with 6.06 deaths per 1000 live births, a figure that is higher than other developed countries (http://tinyurl.com/24s4d7).

Dr. De Jesus concludes:

“Every effort should be made to identify and correct modifiable factors that may account for the increased risk of death after hospital discharge in these extremely premature infants. We feel that information from our study can be used to develop interventions that may help health practitioners with the discharge and follow-up care of these high risk infants.”

Written by Petra Rattue