Journal of Perinatology
January/February 2000, Volume 20, Issue 1, Pages 21 - 26

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Original Article
Impact of Infants Born at the Threshold of Viability on the Neonatal Mortality Rate in Colorado

Jacinto A. Hernández, MD1, Daniel M. Hall, MD1, Edward J. Goldson, MD2, Mary Chase, BA3 & Carol Garrett, PhD4

1Sections of Neonatology (J. A. H., D. M. H.)      2Child Development (E. J. G.), University of Colorado Health Sciences Center      3The Children’s Hospital of Denver, Denver, CO; Child Fatality Review Committee (M. C.); and Health Statistics      4Vital Records (C. G.), Center for Health and Environmental Information and Statistics, Colorado Department of Public Health and Environment, Denver, CO.    

Correspondence to: Jacinto A. Hernández, MD, 1056 East 19th Avenue, B070, Denver, CO 80218.    

This work was supported in part by project H28 MC00006 from the Maternal and Child Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services.
Abstract

OBJECTIVE:

To determine the contribution of infants born at the threshold of viability (<750 gm) on neonatal mortality in Colorado.

STUDY DESIGN:

For the period of January 1991 to December 1996, all Colorado live births who expired were evaluated for gestational age, birth weight, gender, hospital level of care, age at time of death, delivery room resuscitation, mechanical ventilation, medical and surgical complications, and serious malformations.

RESULTS:

Although infants weighing <750 gm represent only 0.31% of all live births, they account for 46.3% of deaths. While those infants weighing <500 gm and with a gestation of <24 weeks almost always died (94.7%), the majority born in the 500- to 745-gm category (55.8%) survived. The vast majority (88.5%) of deaths occurred on the first day of life.

A total of 38.4% of births in which the infant weighed <750 gm occurred outside bona fide regional perinatal centers.

CONCLUSION: Future attempts to reduce the Colorado neonatal mortality rate would best focus on the 500- to 750-gm weight group through the re-regionalization of high-risk perinatal care.

© Macmillan Publishers Ltd 2000