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Changes in perinatal care and survival in very preterm and extremely preterm infants in the Netherlands between 1983 and 1995

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Author: Anthony, S. · Ouden, L.D. · Brand, R. · Verloove-Vanhorick, P. · Gravenhorst, J.B.
Type:article
Date:2004
Source:European Journal of Obstetrics Gynecology and Reproductive Biology, 2, 112, 170-177
Identifier: 237618
doi: doi:10.1016/S0301-2115(03)00328-2
Keywords: Health · Implications · Obstetrical and neonatal management · Survival · Adulthood · Age · Artificial ventilation · Cesarean section · Controlled study · Data base · Delivery · Disease severity · Follow up · Major clinical study · Newborn · Newborn morbidity · Newborn mortality · Obstetric care · Perinatal care · Prematurity · Very low birth weight · Apgar Score · Cause of Death · Female · Humans · Incidence · Infant Mortality · Infant, Newborn · Infant, Premature · Infant, Very Low Birth Weight · Intensive Care Units, Neonatal · Logistic Models · Male · Multivariate Analysis · Netherlands · Perinatal Care · Pregnancy · Probability · Registries · Retrospective Studies · Risk Assessment · Survival Analysis

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. Study design: 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. © 2003 Elsevier Ireland Ltd. All rights reserved.