Aim To study changes in complications and outcome in inborn neonates with a gestational age between 25 and 29.9 weeks in the years 1991–2006.
Subjects and Methods All neonates admitted to the neonatal intensive care unit (NICU) of the Wilhelmina Children’s Hospital were entered in the database. Mortality and morbidity (chronic lung disease (CLD), intraventricular haemorrhage (IVH) grades III or IV, cystic periventricular leucomalacia (cPVL), perforated necrotising enterocolitis (NEC)) were compared in three periods (1991–6, n = 445; 1997–2001, n = 367; 2002–6, n = 430) for all inborn patients (72.8–82.1% of all admitted neonates aged 25–29.9 weeks).
Results See table. Cerebral palsy decreased from 5.2% in period 1 to 2.9% in period 3.
Discussion Patients with a gestational age of 25–29.9 weeks have always been admitted to a NICU and received optimal care. Patients born in our perinatal centre showed a significant reduction in the incidence of cPVL and trends in perforated NEC and cerebral palsy, but not in CLD and IVH grades III or IV.
Conclusions The present study shows improvements in some aspects of neonatal care, but in particular CLD and IVH remain a matter of concern.