Nw. Svenningsen et al., CHANGING TREND IN PERINATAL MANAGEMENT AND OUTCOME OF EXTREMELY LOW-BIRTH-WEIGHT (ELBW) INFANTS, Acta paediatrica, 86, 1997, pp. 89-91
Perinatal care of the extremely preterm and low birthweight (ELBW) inf
ant is founded on basic principles of physiology and knowledge about t
he prevailing pathophysiological mechanisms. New therapies in clinical
care are usually introduced non-uniformly, so more often there is a g
radual rather than a sudden change in the development of perinatal car
e, conceivably involving also an important learning process. This was
confirmed in an evaluation of respiratory care for ELBW infants (n = 3
25) over a 9-year period (1986-1991). Although birthweight (mean 815 g
) and degree of immaturity at birth (mean 26.7 weeks of gestation) did
not change over the years, our trend analysis showed that the surviva
l rate increased from 47% to 70% (p < 0.04) and the percentage of surv
ivors without bronchopulmonary dysplasia and/or major intracranial hae
morrhages (ICH grades 3 and 4) increased from 67% to 87% (p < 0.006).
mie suggest that besides medical treatment per se, refinement and tuni
ng of nursing and medical care procedures will also affect the total o
utcome of ELBW infants.