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Abstract

Background: Very low birth weight (VLBW; <1500 g) and extremely low birth weight (ELBW; <1000 g) infants represent a high-risk group with increased susceptibility to a wide range of neonatal complications and poor outcomes. These conditions remain critical indicators of perinatal health and care quality.
Aim: To assess the complications and immediate outcomes in VLBW and ELBW neonates admitted to a tertiary care neonatal intensive care unit (NICU).
Methods: This hospital-based cross-sectional observational study was conducted over 18 months at Krishna Hospital, Karad. A total of 126 neonates (105 VLBW and 21 ELBW) were enrolled. Maternal and neonatal variables were recorded, including gestational age, birth weight, clinical complications, and outcomes. Data were analyzed and compared between the VLBW and ELBW groups.
Results: Of 3,703 total births, 126 (3.4%) were either VLBW or ELBW. Male infants constituted 53.2% of the study population. The majority were small for gestational age (64%). Mean gestational age and birth weight were 31.9 weeks/1272.8 g for VLBW and 28.5 weeks/898.4 g for ELBW infants. Respiratory distress syndrome (RDS) was the most common complication (78.5%), particularly in ELBW infants (90.4%). Other major morbidities included neonatal jaundice (80.2%), sepsis (22.2%), apnea of prematurity (32.5%), intraventricular hemorrhage (31.7%), and retinopathy of prematurity (22.2%). Metabolic disturbances such as hypoglycemia (12.6%), hypocalcemia (especially in ELBW: 33.3%), and dyselectrolytemia were also observed. ELBW infants experienced significantly higher complication rates across nearly all parameters.
Overall, 74.7% of neonates recovered, with a markedly better recovery rate in VLBW (81.6%) compared to ELBW (33.3%) infants. The overall mortality rate was 19.8%, with 12.7% in VLBW and 61.9% in ELBW groups.
Conclusion: The study underscores the heightened vulnerability of ELBW infants to complications such as RDS, IVH, and sepsis, translating into significantly higher mortality. Early detection, specialized neonatal care, and targeted preventive strategies are essential to improve outcomes in these high-risk neonates