title: Changes in perinatal care and survival in very preterm and extremely preterm infants in The Netherlands between 1983 and 1995.
abstract: OBJECTIVE
  To evaluate changes in obstetrical and neonatal care for very preterm and extremely preterm infants between 1983 and 1995 in The Netherlands and to evaluate the effect of those changes.
  
  
  METHODS
  Data on all very preterm or VLBW infants from the linked national obstetrical and neonatal databases of 1995 (N=2066) were compared to data on similar infants from a nation-wide study of very preterm infants born in 1983 (N=1338).
  
  
  RESULTS
  Obstetrical and neonatal management changed over time, with an increased number of deliveries in tertiary centres (35.7-60.7%), an increase in C-sections (43.7-56.8%) and prolonged artificial ventilation (3.4-9.5%). Survival until discharge increased from 75 to 90% and neonatal morbidity decreased in relative terms.
  
  
  CONCLUSIONS
  The short-term outcome for these very preterm and extremely preterm infants has improved. Long-term follow-up through to school age and adulthood of preterm infants is needed to investigate the changes in the sequelae of intensive obstetrical and neonatal care.
authors.affiliation: Child Health Division, TNO Prevention and Health, PO Box 92215, 2301 CE Leiden, The Netherlands. s.anthony@pg.tno.nl
authors.forename: Sabine
authors.initials: S
authors.lastname: Anthony
authors.forename: Lya den
authors.initials: Ld
authors.lastname: Ouden
authors.forename: Ronald
authors.initials: R
authors.lastname: Brand
authors.forename: Pauline
authors.initials: P
authors.lastname: Verloove-Vanhorick
authors.forename: Jack Bennebroek
authors.initials: JB
authors.lastname: Gravenhorst
mesh_terms: D001034:Apgar Score; D002423:Cause of Death; D005260:Female; D006801:Humans; D015994:Incidence; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D018743:Perinatal Care / Q000592:standards* / Q000639:trends; D011247:Pregnancy; D011336:Probability; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis