Complications affecting preterm neonates from 1991 to 2006: what have we gained?

Aim: In this study, we determined whether outcome of preterm neonates has improved over a period of 16 years. Study design: Inborn neonates with a gestational age of 25.0-29.9 weeks were included. Patients with severe congenital malformations were excluded. Mortality and morbidity (chronic lung disease; CLD, intraventricular haemorrhage: IVH grade III or IV, cystic periventricular leukomalacia: cPVL, perforated necrotizing enterocolitis: NEC, severe retinopathy of prematurity needing surgery: ROP and cerebral palsy: CP) were compared in three periods (period 1: 1991-1996 n = 434; period 2: 1997-2001 n = 356; period 3: 2002-2006 n = 422). Results: Infant mortality decreased from 15.2% to 10.9%. CLD did not differ significantly between periods (14.1-14.8%). Perforated NEC decreased from 2.8% to 1.6%. IVH grade III and IV both remained at 5.7% in period 3, whereas cPVL decreased significantly from 4.5% to 1.6%. Cerebral palsy decreased from 5.8% to 3.5% in period 3. Two neonates in each period were in need of surgery for ROP. Conclusion: Inborn preterm patients showed an improved survival and a significant reduction in cPVL and CP. Perforated NEC showed a trend to decrease. CLD and IVH grade III and IV remain a matter of concern.