Survival		Survival is clearly the most important issue while the baby is in the NICU. However, it is usually of less concern to the pediatrician, for many reasons. First, he may not be aware of the patient's admission to the NICU. He may not even know the family yet. He will certainly not be involved in the day-to-day management of the baby's care. And, obviously, he will only be seeing and following the NICU survivors. Nevertheless, it is such an important issue that it must be addressed. Numerous studies have documented the dramatic increase in survival rates of premies since the 1980s. They have also shown relatively unchanged survival figures in the past 10 years. The factors that have consistently been shown to influence survival are Bwt and GA (decreased survival with decreasing Bwt/GA); gender (increased survival in females); and use of prenatal steroids and postnatal surfactant (both leading to increased survival). Interestingly, about 75% of mortality occurs in the first 4-7 days of life, so survival after that time is much less influenced by these factors, especially Bwt/GA. 10-15% of mortality occurs after 28 days of age, so studies that only track survival to that time may overestimate survival. And studies consistently show 2-3% post-NICU-discharge mortality, much of which is related to infection. The latest published summary of national vital statistics is for 2004. This data shows a stable birth rate since 2000, although it has decreased each decade since the 1950s. It also shows an increasing preterm birth rate - job security for the neonatologist. As mentioned earlier, articles differ in how they report survival - by Bwt, by GA and in each category it is grouped differently. The accompanying page is a compendium of the latest survival data. Return to top of page