The prognosis of low-birth-weight infants undergoing major surgery

The outcome of 158 infants of low birth weight (LBW) undergoing major surgical procedures was studies. Eighty-four patients were operated on for congenital malformations, mainly atresia of the esophagus, duodenum, and small bowel. Laparotomy for necrotizing enterocolitis (NEC) or idiopathic perforation of the intestine and ligation of a patent ductus arteriosus (PDA) were the most common acquired disorders requiring surgery. In the very LBW (less than 1500 g) group, 73% of the patients underwent operations for acquired lesions. The overall mortality was 23% and for the the very LBW infants 32%. The survival rate was better for the congenital disorders (87%) than the acquired lesions (66%) as a whole, but was about the same in the very LBW subgroups. The survival rate correlated with both birth weight and gestational age in the congenital anomalies, but not in the acquired disorders subgroup; here the prognosis was mainly determined by the severity of the underlying disease.