• Sabine Anthony, Lya den Ouden, Ronald Brand, Pauline Verloove-Vanhorick, and Jack Bennebroek Gravenhorst.
• Child Health Division, TNO Prevention and Health, PO Box 92215, 2301 CE Leiden, The Netherlands. s.anthony@pg.tno.nl
• Eur. J. Obstet. Gynecol. Reprod. Biol. 2004 Feb 10;112(2):170-7.

ObjectiveTo 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 DesignData 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).ResultsObstetrical 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.ConclusionsThe 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.

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