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Objective: To describe trends in mortality, major morbidity, and perinatal care practices of very low birth weight infants born at NEOCOSUR Neonatal Network centers from January 1, 2001, through December 31, 2016., Study Design: A retrospective analysis of prospectively collected data from all inborn infants with a birthweight of 500-1500 g and 23-35 weeks of gestation., Results: We examined data for 13 987 very low birth weight infants with a mean birth weight of 1081 ± 281 g and a gestational age of 28.8 ± 2.9 weeks. Overall mortality was 26.8% without significant changes throughout the study period. Decreases in early onset sepsis from 6.3% to 2.8% (P <.001), late onset sepsis from 21.1% to 19.5% (P = .002), retinopathy of prematurity from 21.3% to 13.8% (P <.001), and hydrocephalus from 3.8% to 2.4% (P <.001), were observed. The incidence for bronchopulmonary dysplasia decreased from 17.3% to 16% (P = .043), incidence of severe intraventricular hemorrhage was 10.4%, necrotizing enterocolitis 11.1%, and periventricular leukomalacia 3.8%, and did not change over the study period. Administration of antenatal corticosteroids increased from 70.2% to 82.3% and cesarean delivery from 65.9% to 75.4% (P <.001). The use of conventional mechanical ventilation decreased from 67.7% to 63.9% (P <.001) and continuous positive airway pressure use increased from 41.3% to 64.3% (P <.001). Survival without major morbidity increased from 37.4% to 44.5% over the study period (P <.001)., Conclusions: Progress in perinatal and neonatal care at network centers was associated with an improvement in survival without major morbidity of very low birth weight infants during a 16-year period. However, overall mortality remained unchanged., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Therapeutic hypothermia is the standard of care for hypoxic-ischemic encephalopathy (HIE). This treatment was implemented at a regional level by the perinatal network of the City of Buenos Aires. The following are the objectives of this article: 1. To describe the implementation of the network's hypothermia treatment program; 2. To report treatment-associated complications, adverse events and mortality. The program was implemented in stages: 1) 2009-2010. Training and instruction on how to use the equipment. 2) 20102014. Treatment and follow-up of patients with moderate or severe HIE. Up to October 2014, 27 newborn infants received hypothermia treatment with moderate (n= 15) and severe (n= 12) HIE. None of the patients died during treatment. Three newborn infants were lost to follow-up. Among the 16 survivors older than one year old, three have severe neurological disability. Program implementation was plausible. It is imperative to train health care providers on how to identify patients with HIE.

Introduction: The Neonatal Network of Public Hospitals in the city of Buenos Aires closely monitors the progress of newborn infants with a birth weight less than 1500 g (very low birth weight, VLBW) because it largely contributes to neonatal morbidity and mortality., Objective: To analyze the morbidity and mortality of VLBW infants and determine their riskadjusted mortality using the score of the South American Neonatal Network (Red Neonatal de los países del Conosur de América, NEOCOSUR)., Material and Methods: Live infants born in the network hospitals with a birth weight of 500-1499 g between 2008 and 2010 were included in the study. Data was recorded prospectively using a standardized methodology. Mortality, morbidity and risk-adjusted mortality rates according to the NEOCOSUR score were estimated. Results. There were 92,698 infants born during the study period. Of them, 1.26% weighed less than 1500 g at birth. Only 40.4% of these received a full course of antenatal corticosteroids. A total of 62.7% of these developed respiratory distress syndrome, 5.4% enterocolitis, 10.1% intracranial hemorrhage, and 13.4% severe retinopathy. Early sepsis was observed in 5.6%, and late sepsis in 9.6%. Bronchopulmonary dysplasia was present in 10.7% of the cases. Neonatal mortality was 29.2%, and the adjusted mortality with no major malformations was 25.4%. Survival of infants with a birth weight of =750 g and a gestational age of =26 weeks was 50%. The observed/expected mortality ratio was 1.04, with a large variability., Conclusions: The percentage of VLBW infants who received antenatal corticosteroids was low. The incidence of sepsis and the rate of infants with severe retinopathy of prematurity are high. The risk-adjusted mortality is higher than expected.

Our aim was to assess the effectiveness of neonatal treatment of Rh hemolytic disease with high-dose intravenous immunoglobulin (HDIVIG), in reducing neonatal hemolysis. A total of 40 neonates born to isoimmunized Rh negative women were studied. The population was randomized into 2 groups: Group 1 received IVIG 800 mg/kg/day for 3 days, plus phototherapy; and Group 2 received only phototherapy. No significant difference was observed between the groups in the severity of either the antenatal and neonatal disease, mode of delivery, mean birthweight, gestational age at delivery, proportion of preterm deliveries, 1 minute Apgar Score, days of phototherapy, and presence of neonatal cholestasis. Group 1 babies showed a significantly decreased duration of hospitalization, less hemolysis, and a less marked increase in bilirubin levels on the first day of life than Group 2 newborns. Therefore, Group 1 neonates received less treatment with transfusions (exchange-transfusions and/or simple blood treatment with transfusions) than those in Group 2. Our data suggest that the frequency of transfusional therapy can be reduced by combining conventional phototherapy with HDIVIG. Further studies are needed to determine the optimum timing and dosages of neonatal HDIVIG treatment.