Clinical Outcomes of Very Low Birth Weight Infants until Hospital Discharge over Two Decades: A Cohort Study in a Tertiary Hospital in Riyadh, Kingdom of Saudi Arabia

Objective: The objective of this study was to report the survival rate and outcomes of key clinical variables for babies <1500 g at birth over two decades. Methods: This is an analysis of prospectively collected data at a tertiary neonatal care center in the central region of Saudi Arabia. All inborn babies with a birth weight (BW) of <1500 g admitted to the neonatal intensive care unit at Prince Sultan Military Medical City between January 2000 and December 2019 were included. Main outcome measures included survival rate and prevalence of retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), neonatal respiratory distress syndrome (NRDS), chronic lung disease (CLD), patent ductus arteriosus (PDA), and infections. Results: There were 186,986 infants born during the study period, 3263 of whom were <1500 g. In this cohort, the clinical outcomes (for death, morbidity, or combined) included ROP (17%), infections (33.8%), NRDS (80.7%), CLD (27.5%), IVH (20.4%), NEC (10.5%), and PDA (40.0%). The overall survival rates in babies with BWs of <1500 g and <1000 g were 82.5% (95% confidence interval [CI]: 81.2–83.8) and 68.5% (95% CI: 66.0–71.0), respectively. The survival rate in babies <500 g was 27%. A total of 572 babies (17.5%) died. Lethal malformations were the direct cause of death in 109 babies (19%). Conclusions: This large sample of babies who were <1500 g (3263) provided valuable data on the prevalence of major neonatal morbidities and survival rate over two decades.