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PEDIATRICS Vol. 101 No. 6 June 1998, pp. 975-978

Actuarial Survival in the Premature Infant Less Than 30 Weeks' Gestation

Received Jun 2, 1997; accepted Oct 24, 1997.

Timothy R. Cooper*, Dagger , Carol L. Berseth*, Dagger , James M. Adams*, and Leonard E. Weisman*

From the * Neonatology Section, Department of Pediatrics, and the Dagger  Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas.

Objective.  Because survival from admission to discharge does not provide parents and physicians information about future life expectancy in the premature neonate, we characterized the actuarial survival, defined as the future life expectancy from a given postnatal age, in a large inborn population of premature infants <30 weeks' gestation.

Study Design.  We determined daily actuarial survival of 1925 inborn infants (23 to 29 weeks' gestation) admitted to the Baylor Affiliated Nurseries from July 1986 through December 1994, stratified by 100-g birth weight and by 1-week gestational-age intervals.

Results.  In the 501- to 600-g birth weight stratum, actuarial survival improved from 31% at birth, to 61% on day of life 7, and then to 75% on day of life 28; in the 901- to 1000-g birth weight stratum, actuarial survival improved from 88%, to 94%, and then to 98% throughout the same times, respectively. Similar trends were obtained when data were stratified by gestational age.

Conclusions.  Survival in the smallest infants improves dramatically during the first few days of life, but there is a significant risk for late death in the smallest of these infants.

Key words: survival analysis, counseling, decision making, policy making, infant mortality, forecasting.




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