%0 Journal Article
%T Population based trends in mortality, morbidity and treatment for very preterm- and very low birth weight infants over 12 years
%A Christoph R¨¹egger
%A Markus Hegglin
%A Mark Adams
%A Hans Bucher
%A the Swiss Neonatal Network
%J BMC Pediatrics
%D 2012
%I BioMed Central
%R 10.1186/1471-2431-12-17
%X Our population-based observational cohort study used the Minimal Neonatal Data Set, a database maintained by the Swiss Society of Neonatology including information of all VP- and VLBW infants. Perinatal characteristics, mortality and morbidity rates and the survival free of major complications were analysed and their temporal trends evaluated.In 1996, 2000, 2004, and 2008, a total number of 3090 infants were enrolled in the Network Database. At the same time the rate of VP- and VLBW neonates increased significantly from 0.87% in 1996 to 1.10% in 2008 (p < 0.001). The overall mortality remained stable by 13%, but the survival free of major complications increased from 66.9% to 71.7% (p < 0.01). The percentage of infants getting a full course of antenatal corticosteroids increased from 67.7% in 1996 to 91.4% in 2008 (p < 0.001). Surfactant was given more frequently (24.8% in 1996 compared to 40.1% in 2008, p < 0.001) and the frequency of mechanical ventilation remained stable by about 43%. However, the use of CPAP therapy increased considerably from 43% to 73.2% (p < 0.001). Some of the typical neonatal pathologies like bronchopulmonary dysplasia, necrotising enterocolitis and intraventricular haemorrhage decreased significantly (p ¡Ü 0.02) whereas others like patent ductus arteriosus and respiratory distress syndrome increased (p < 0.001).Over the 12-year observation period, the number of VP- and VLBW infants increased significantly. An unchanged overall mortality rate and an increase of survivors free of major complication resulted in a considerable net gain in infants with potentially good outcome.Very preterm birth is a major cause of mortality and morbidity for newborns and imposes a considerable burden on limited health care resources. Over the last two decades, changes in perinatal management have been associated with a significant increase and better outcome of these infants [1,2]. However, the majority of these reports are based on single centres or neonatal n
%U http://www.biomedcentral.com/1471-2431/12/17