[Treatment of very-low-birth-weight infants in Norway the last 40 years]

Treatment of very-low-birth-weight infants has changed significantly in the last decades.

Medical records were assessed retrospectively with respect to details in diagnostic and treatment characteristics for three cohorts (born in 1970, 1980 or 1989) from Rikshospitalet, Oslo and two from St. Olavs hospital (born in 1997 and 2007), Trondheim.

Few infants were given intensive care in 1970, still infants with a gestational age (GA) of 25 weeks survived. From 1980, infants down to GA 23 weeks were treated. Overall survival did not change, but infants lived longer before they died. From 1980 to 1989, survival improved from 73 % to 82 %, and some infants with GA 23 weeks also survived. This improuval was probably related more to prenatal and obstetric care than to postnatal care. Mortality has continued to decrease from 1989 to 2007, and infants weighing > 1000 g now rarely die. More than 80 % of children weighing < 1000 g also survive. As an increased number of extremely premature infants are now treated, overall morbidity in survivors is still around 30 %.

Despite improved treatment results for very-low-birth-weight infants, treatment of the smallest among them is still a challenge.