Neurodevelopmental outcome of babies weighing less than 2001 g at birth: influence of perinatal transfer and mechanical ventilation.

From 1976 to 1980, 1034 children who had weighed less than 2001 g at birth were cared for at the North Western regional neonatal intensive care unit. Of these, 315 babies were neonatal referrals and 91 were born in the unit after antenatal transfer from their district hospital. Significantly fewer of the babies referred as neonates survived (n = 167, 53%) compared with 67 of the antenatal referrals (74%), and 490 of those born in the unit (78%). They also had a higher incidence of major handicaps (24 of 167, 14%) compared with six of 67 (9%) of the antenatal referrals and 35 of 490 (7%) of those born in the unit. To control for selection bias among neonatal referrals, the outcome of ventilated neonatal referrals was compared with that of ventilated babies born in the unit. The two groups were comparable for the incidence of a wide range of neonatal complications. No differences in rates of survival or handicap were found. We conclude that sick babies transferred after birth to regional neonatal intensive care units have similar short and long term outcomes to sick babies born in regional units.