72 Extremely low birth weight and survival among babies born with oesophageal surgery
Elizabeth O'Connor, Bruce Jaffray
The Great North Children's Hospital, Newcastle upon Tyne, United Kingdom

Abstract

Aims: We examined the effect of extremely low birth weight (ELBW) (<1kg), and its combination with other anomalies on oesophageal atresia (OA) survival.

Methods: We identified all babies born with OA in our region over the last 20 years.  The outcome of interest was death.  Possible predictor variables were: birth weight, gestation, cardiac, renal, neurological state, abnormal karyotype, primary anastomosis, anastomotic leak, or combinations thereof.

Statistical analysis: Categorical variables were compared using Χ2 test, or Fisher’s exact test when frequencies were less than 5.  Relationship between continuous variables and death was measured with logistic regression. Significance was less than 5%.

Results: 172 babies were born with OA. Median birth weight was 2.4kg (range 0.68-4.1), and 5 had birth weight ≤1kg. 20 babies (12%) died.  In the ELBW group, mortality was 2/5 40%, while mortality among babies with birth weight >1kg, was 11% (p = 0.1). Both non-survivors in the ELBW group had both severe renal and cardiac anomalies. The frequency of this combination was significantly higher in the ELBW group than in the >1kg birth weight group, Χ2 =20.9, p<0.001. Gestation was significantly associated with survival.  Each week of gestation decreased the odds of death by 0.8 (0.7-0.9) p = 0.01. Failure to achieve a primary anastomosis was associated with 100% mortality, and was significantly more common in the ELBW group (2/5 vs 12/155 p = 0.008).

Conclusions:  ELBW is associated with a higher frequency of combined cardiac/renal anomalies, and failure to achieve primary anastomosis.  ELBW is not predictive of death when confounding variables are analysed.

Birth weight

 

Neither cardiac nor renal

Either cardiac or renal

Both cardiac and renal

Total

≤1 kg

Alive

3

0

0

3

Dead

0

0

2

2

>1kg

Alive

125

23

1

149

Dead

2

13

3

18

Total

 

130

36

6

172

 


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