MORTALITY AND MORBIDITY OF NATIONWIDE VERY LOW GESTATIONAL AGE INFANT POPULATIONS BETWEEN 2002–2003 AND 2007 IN ESTONIA

Objective Perinatal mortality rate per 1000 births has decreased from 20.1 to 5.6 in Estonia in 1992–2006. Our goal was to investigate whether short-term outcome in very low gestational age infants (VLGAI) has changed over time in Estonia. Methods All VLGAI (22–31 gestational weeks) admitted to neonatal intensive care in Estonia in 2002–2003 and 2007 were included into the study. Data from 2007 were collected in a national VLGAI research register and from 2002–2003 retrospectively by reviewing hospital charts. Results A total of 218 and 186 VLGAI were admitted to neonatal intensive care during 2002–2003 and 2007, respectively. The proportion of extremely premature infants (22–26 gestational weeks) was 26% in both groups. In-hospital mortality rates were 17% and 16%, respectively (p = 0.71). The incidence of respiratory distress syndrome increased from 85% to 93% over the study period (p = 0.015). The incidence of oxygen dependency at 36 weeks postmenstrual age (21% vs 20%), late-onset blood culture positive sepsis (26% vs 23%), intraventricular haemorrhage grades 3–4 (16% vs 13%), necrotizing enterocolitis grades 2–3 (8% vs 13%) and retinopathy of prematurity requiring laser therapy (12% vs 9%) did not change significantly. Regional differences in in-hospital mortality and morbidity were found. Conclusions Although more VLGAI were admitted to neonatal intensive care in the 2nd period, no significant changes were detected in mortality rate and morbidity. Online register-based follow-up of neonatal mortality and morbidity is continued in Estonia to work out effective strategies for further improvement of the outcome of VLGAI.