Survival to discharge of a cohort of very low birth weight infants born in Lombardy between 1999-2002

Objectives. Information on survival until hospital discharge of very low birth weight infants (VLBWI) in Italy is very scant. The aims of this study were to describe the survival rate of a cohort of 2228 VLBWI, reporting data for gestational age and birthweight groups; report the temporal distribution of deaths during hospital stay through life-table analyses; and estimate the probability of survival at various days of postnatal age at different gestational age weeks ("actuarial survival"). Methods. Analysis of the outcome at hospital discharge in a cohort of 2228 VLBWI born between 1999-2002 in Lombardy, referred to 14 neonatal intensive care units participating in the Neonatal Network of the Lombardy Region. Results. Mortality rate was 14.3% overall, varying from 100% mortality at 21 and 22 weeks, to 3% or less from 30 weeks onwards. The risk of dying was 11.9 times greater in infants with birth weight < 1000 g (n = 812) than in those with a birth weight of 1000 g or more (n = 1416). At low gestational age, the risk of dying continued for several days after birth, and more than 40% of deaths of infants born at 24-28 weeks occurred after 7 days of life. Conclusions. This study provides estimates of survival for a large cohort of VLBWI, based on a recent and multicenter sample. Life-table analyses and actuarial survival can provide useful information for clinicians involved in parental counselling.