title: Complications affecting preterm neonates from 1991 to 2006: what have we gained?
abstract: OBJECTIVE
  In this study, we determined whether outcome of preterm neonates has improved over a period of 16 years.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neonatology, Perinatal Centre, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, The Netherlands. f.groenendaal@umcutrecht.nl
authors.forename: F
authors.initials: F
authors.lastname: Groenendaal
authors.forename: J U M
authors.initials: JU
authors.lastname: Termote
authors.forename: M
authors.initials: M
authors.lastname: van der Heide-Jalving
authors.forename: I C
authors.initials: IC
authors.lastname: van Haastert
authors.forename: L S
authors.initials: LS
authors.lastname: de Vries
mesh_terms: D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care