536 EFFECT OF APGAR SCORE ON SURVIVAL OF THE VLBW INFANT

To plan appropriate obstetric and pediatric intervention for pregnancies resulting in VLBW infants, the physician needs to be informed of outcome data at the delivering institution. We reviewed 9552 live births from Jan ′82 through Aug ′84 when our crude neonatal mortality rate was 15.5 and our VLBW rate was 3.8%. Because of rapidly improving outlook for VLBW infants, BW and GA specific mortality analysis by 100g increments or 1 week GA intervals is essential. Of 137 neonates, weighing 600-1499g, with Apgar score of 4 or more, the survival was 93%. For 190 neonates between 23 & 32 weeks GA, with 1 min. Apgar score of 4 or more, survival was 94%. g ao When the 1 min Apgar score was 3 or less, survival was 51% and 57% for comparable BW and GA groups. Prolongation of pregnancy is the most important factor to improve outcome for the VLBW infant; when this is not possible assuring optimal condition at birth becomes the highest priority.