[Unpreventable effects of neonatal intensive care on the later development of extremely small premature infants]

This review of the literature presents the pooled data from several perinatal centers throughout the world published during the last three years. It regards the longterm prognosis of extremely low birthweight infants (less than 1000 g). Since the introduction of neonatal intensive care the mortality rate dropped from greater than 90% to less than 50%. On the other hand the morbidity rate improved only slowly. Recent reports from the Anglo-American literature show that among the survivors 13.7% are seriously and 25.1% mildly handicapped. 60-70% of the extremely low birthweight infants, despite of normal IQ's, are experiencing school problems. Most of them have cognitive, perceptual and motor deficits combined with behaviour problems ("the new morbidities"). The incidence of cerebral palsy remained unchanged (6-8%) over the last two decades. Until now, there is no significant effect of the surfactant therapy on the morbidity rate. The rate of serious longterm disability increases with decreasing birthweight. The results of the Anglo-American and German follow-up studies differ only slightly.