The clinical review of international data about morbidity and mortality of children with very low and extremely low birth weight is presented in this article. The risk factors of unfavorable outcomes and increasing possibilities for survival were analyzed. It was defined that the morbidity and mortality of very preterm infants, especially with the extreme degree of immaturity, vary greatly and depend on the socio-economic background, level of medical care and baseline characteristics of the newborn. However, every newborn, even in relatively equal conditions, has a "degree of stability", which is determined by biological and genetic factors, the characteristics of the course of the perinatal period and numerous external reasons. The author focuses on the most vulnerable and challenging population of children born in the zone limit of viability earlier than 25 weeks of gestation and weighing less than 700g. She noted that the detailed analysis of the causes of death with the release of the risk factors of adverse outcome is extremely important, especially for relatively promising group of children born with a gestational age of 25 weeks or more. They are the reserve on ways to further reduce neonatal and infant mortality in Russia.
newborns, very low weight, extremely low birth weight, morbidity, mortality.
1. Aylamazyan E.K., Evsyukova I.I. Diskussionnye problemy prezhdevremennykh rodov i vykhazhivaniya detey s ekstremal´no nizkoy massoy . Zhurnal akusherstva i zhenskikh bolezney. 2011. № 3. S. 183-189.
2. Bashmakova N.V., Kayumova A.V., Melkozerova O.A. Analiz vedeniya prezhdevremennykh rodov, zakonchivshikhsya rozhdeniem detey s ENMT: pervyy opyt v eru novykh kriteriev zhivorozhdeniya. Aku-sherstvo i ginekologiya. 2013. № 6. C. 41-45.
3. Vyzhivaemost´ i aktual´nye perinatal´nye tekhnologii pri vykhazhivanii novorozhdennykh s ekstremal´no nizkoy massoy tela / Bashmakova N.V. [i dr.]. Rossiyskiy vestnik akushera-ginekologa. 2012. № 1. S. 4-7.
4. Baybarina E.N., Sorokina Z.Kh. Iskhody beremennosti v sroke 22-27 nedel´ v meditsinskikh uch-rezhdeniyakh Rossiyskoy Federatsii. Voprosy sovremennoy pediatrii. 2011. T.10, №1. S.17-20.
5. Perekhod Rossiyskoy Federatsii na mezhdunarodnye kriterii registratsii rozhdeniya detey: vzglyad organizatora zdravookhraneniya / E.N. Baybarina [i dr.]. Akusherstvo i ginekologiya. 2011. № 6. P. 1-4.
6. Valiulina A.Ya., Akhmadeeva E.N., Kryvkina N.N. Problemy i perspektivy uspeshnogo vykha-zhivaniya i reabilitatsii detey, rodivshikhsya s nizkoy i ekstremal´no nizkoy massoy tela. Vestnik so-vremennoy klinicheskoy meditsiny. 2013. T.1, №6. S. 34-41.
7. Vedenie detey, rozhdennykh s ekstremal´no nizkoy massoy tela. Klinicheskiy obzor mezhduna-rodnykh dannykh. Informatsionno-obrazovatel´nyy vestnik «Zdorov´e sem´i». 2011. № 2. 20 s.
8. Vinogradova I.V., Krasnov M.V. Sostoyanie zdorov´ya detey s ekstremal´no nizkoy massoy tela pri rozhdenii i v otdalennye periody zhizni. Vestnik sovremennoy klinicheskoy meditsiny. 2013. T.6, №1. S. 20-25.
9. Glukhovets N.I., Belousova N.A., Popov G.G. Osnovnye prichiny smerti novorozhdennykh s eks-tremal´no nizkoy massoy tela. Rossiyskiy vestnik perinatologii i pediatrii. 2004. № 5. S. 61.
10. Intensivnaya terapiya i printsipy vykhazhivaniya detey s ekstremal´no nizkoy i ochen´ nizkoy massoy tela pri rozhdenii. Metodicheskoe pis´mo / Pod red. E.N. Baybarinoy, D.N. Degtyareva, V.I. Shi-rokovoy. M.: Ministerstvo zdravookhraneniya i sotsial´nogo razvitiya Rossii, FGU «NTs akusherstva, ginekologii i perinatologii im. akademika V.I. Kulakova», 2011. 71 s.
11. Kovalenko T.V., Zernova L.Yu., Babintseva N.V. Rezul´taty vykhazhivaniya detey s ekstremal´no nizkoy massoy tela. Prakticheskaya meditsina. 2013. T.75, №6. S.84-89.
12. Pavlov O.G. Sistemnoe vliyanie nasledstvennoy predraspolozhennosti k somatopatologii i mediko-sotsial´nykh faktorov na techenie beremennosti i iskhod rodov: Dissertatsiya … doktora medi-tsinskikh nauk. Tula: GOUVPO "Tul´skiy gosudarstvennyy universitet", 2006. 295 s.
13. Pavlov O.G. Vliyanie nasledstvennoy predraspolozhennosti k somatopatologii i mediko-sotsial´nykh faktorov na techenie beremennosti i iskhod rodov s pozitsiy sistemnogo analiza/ Pod red. N.M. Agarkova, V.G. Volkova. Kursk: Kurskiy gos. tekhnicheskiy un-t, 2006. 236 s.
14. Pavlov O.G., Mart´yanov D.V. Sistemo-obrazuyushchie faktory razvitiya rannikh poslerodovykh infektsiy. Vestnik novykh meditsinskikh tekhnologiy. 2011. T. 18, № 1. S. 23-25.
15. Sorokina Z.Kh. Tsentralizatsiya pomoshchi novorozhdennym: znachimost´ i metod otsenki . Vopro-sy prakticheskoy pediatrii. 2008. T.3, № 6. S. 59-62.
16. Fatykhova N.R., Gamirova R.G., Prusakov V.F. Otdalennye rezul´taty vykhazhivaniya detey s ekstremal´no nizkoy massoy tela. Obshchestvennoe zdorov´e i zdravookhranenie. 2014. №2. S. 31-34.
17. Alfirevic Z., Milan S.J., Livio S. Caesarean section versus vaginal delivery for preterm birth in single-tons. Cochrane Database Syst. Rev. 2012. Vol. 13. № 6:CD000078.
18. Arad I., Braunstein R., Bar-Oz B. Neonatal outcome of inborn and outborn extremely low birth weight Infants: rele-vance of perinatal factors. IMAJ. 2008. Vol. 10. P. 457-460.
19. Changes in care and short-term outcome for very preterm infants in Estonia / Toome L. [et al.]. Acta Paediatr. 2012. Vol.101, № 4. R. 390-396.
20. Fetal sex pairing and adverse perinatal outcomes in twin gestations / Mulla Z.D. [et al.] //Ann. Epide-miol. 2013. Vol. 23, № 1. P. 7-12.
21. Intensive care for extreme prematurity-moving beyond gestational age / Tyson J.E. [et al.]. N Engl. J. Med. 2008. Vol. 358, №16. P. 1672-1681.
22. Level and volume of neonatal intensive care and mortality in very-low-birth-weight infants / Phibbs C.S. [et al.]. N Engl J Med. 2007. Vol. 356, №21. P. 2165-2175.
23. Mohamed M.A., Nada A., Aly H. Day-by-day postnatal survival in very low birth weight infants. Pediatr Neonatol. 2010. Vol 51, № 3. P. 160-165.
24. Morbidity and Mortality of Infants With Very Low Birth Weight in Japan: Center Variation / Kusu-da S. [et al.]. Pediatrics. 2006. Vol.118. P. 1130-1138.
25. Muhuri R.K., Macdorman M.F., Menacker F. Method of delivery and neonatal mortality among very low birth weight infants in the United States. Matern Child Health J. 2006. Vol. 10, №1. P. 47-53.
26. Neurodevelopmental outcome in extremely preterm infants at 2.5 years after active perinatal care in Sweden / Serenius F. [et al.]. JAMA. 2013. Vol. 309, №17. R. 1810-1820.
27. Neurodevelopmental outcomes at 4 to 8 years of children born at 22 to 25 weeks’ gestational age. A Meta-analysis / Moore G.P. [et al.]. JAMA Pediatrics. 2013. Vol. 167, № 10. R. 967-974.
28. Neurodevelopmental outcomes of preterm very low birth weight infants born from 2005 to 2007 / Or-cesi S. [et al.]. Eur J Paediatr Neurol. 2012. Vol. 16, № 6. P. 716-723.
29. One-year survival of extremely preterm infants after active perinatal care in Sweden / Fellman V. [et al.]// JAMA. 2009. Vol. 301, № 21. R. 2225-2233.
30. Outcome trajectories in extremely preterm infants /Ambalavanan N. [et al.]. Pediatrics. 2012. Vol. 130, №1. P. 115-125.
31. Outcomes of infants born at 22 and 23 weeks’gestation / Ishii N. [et al.]// Pediatrics. 2013. Vol. 132. R. 1-10.
32. Outcomes of very low birth weight infants at three years of age born in 2003-2004 in Japan / Kono Y. [et al.]. Pediatr Int. 2011. Vol. 53, № 6. R. 930-935.
33. Outcomes of very low birth weight infants in Songklanagarind Hospital / Chanvitan P. [et al.]. J. Med. Assoc. Thai. 2010. Vol. 93, №2. P.191-197.
34. Perinatal care at the limit of viability between 22 and 26 completed weeks of gestation in Switzerland. 2011 revision of the Swiss recommendations / Berger T.M. [et al.]. Swiss Med Wkly. 2011. Vol. 141. P. 13280.
35. Perinatal regionalization for very low-birth-weight and very preterm infants. A Meta-analysis / Lass-well S.M. [et al.]. JAMA. 2010. Vol. 304, № 9. R. 992-1000.
36. Prediction of mortality in very premature infants: a systematic review of prediction models / Med-lock S. [et al.]. PLoS One. 2011. Vol. 6, №9. P. 234-241.
37. Resuscitation in the "gray zone" of viability: determining physician preferences and predicting infant outcomes / Singh J. [et al.]. Pediatrics. 2007. Vol. 120. P. 519-526.
38. Rocha G., Guimarães H. On the limit of viability extremely low gestational age at birth. Acta Med Port. 2011. Vol. 24, №2. R. 181-188.
39. Survival rate and prevalence of bronchopulmonary dysplasia in extremely low birth weight infants / Latini G. [et al.]. Early Hum. Dev. 2013. Vol. 89, № 1. R. 69-73.
40. The contribution of preterm birth to infant mortality in the United States / Callaghan W.M. [et al.]. Pediatrics. 2006. Vol. 118. P. 1566-1573.
41. The time to death for extremely low birth weight infants in the neonatal intensive care Unit / Nak-hla T. [et al.]. The Internet Journal of Pediatrics and Neonatology. 2007. Vol. 6, № 2.
42. Twin Gestation and Neuro-developmental Outcome in Extremely Low Birth Weight Infants / Wad-hawan R. [et al.]. Pediatrics. 2009. Vol. 123, N.2. P. 220-e227.
