Outcome and hospital cost for infants weighing less than 500 grams: A tertiary centre experience in Taiwan

Aim: To determine the outcome and hospital cost for infants weighing <= 500 g at a tertiary centre in Taiwan. Methods: We retrospectively reviewed the medical records of infants who were born alive with birthweight <= 500 g at the National Taiwan University Hospital from 1997 to 2004. Their outcome and hospital cost were analysed. Results: A total of 168 infants were included for analysis that 146 of them died after compassionate care in the delivery room and 22 received postnatal resuscitation. The infants who received resuscitation were more likely to have higher birthweights, older gestational ages and multiple births compared with those who received compassionate care. After resuscitation, five of the infants died and 17 were admitted to neonatal intensive care unit (NICU) for further management. Subsequently, 12 infants died and five infants survived to discharge. Two infants were discharged against advice and died within days. After exclusion of those receiving compassionate care, the NICU survival rate was 22.7% and the long-term survival rate was 13.6%. The most common early morbidities were respiratory distress syndrome, intraventricular haemorrhage and patent ductus arteriosus, whereas the late morbidities included cholestatic jaundice, retinopathy of prematurity and chronic lung disease. The average total hospital costs for the NICU survivors with birthweight <= 500 g was US$ 42 411 and the average hospital cost per day was US$ 350. Conclusions: Exclusive compassionate care was given to the majority of the infants weighing <= 500 g in Taiwan. The survival rate remained low in these marginally viable infants.