The level of neonatal and perinatal care that is provided has been improving over the past few decades. This improved care has resulted in better outcomes of extreme premature babies. To examine the effect of the improved quality of care we performed a study on infants that were admitted to our NICU. Seventy-one infants born at a gestational age of 28 weeks or less were admitted to the St. Vincent's Medical Center Level III NICU. Twenty-four of these infants (33.8%) died and forty-seven (66.2%) survived. The mean gestational age of all the admissions was 25.7 weeks. Of the infants who died the mean age was 24.9 weeks, while those survived had an average gestational age of 26.5 weeks. Thirty-four of the infants who survived (72.3%)were followed to assess their neuro-developmental outcome. Most of these infants required ventilatory support for RDS/BPD. The ventilatory days ranged from 2 to 74 days and the length of stay ranged from 53 to 128 days. The incidence of IVH in the infants who were followed was 14.8%. Of the 34 infants, three had a grade II bleed and two had a grade III bleed; two of these required a VP shunt for hydrocephalous. The incidence of ROP in the 34 infants followed was 70%; 12 of them had stage II and 12 had stage III. Of the 12 babies who had stage III ROP, 5 of them required cryotherapy. For developmental assessment the Bayley Test and the neurological examination was performed at 18 months corrective age. This revealed that 7 infants (20%) had a significant delayed performance, 5 infants (14.7%) had mildly delayed performance, and another 5 infants (14.7%) had minimum motor function impairment. The development of the remaining infants has been as expected given their age. As a whole, the incidence of the problems mentioned above has decreased over the years to the levels stated. As the rapid progress in medical care is resulting in increased survival of very low birth weight infants, long term follow-up of these babies is warranted to assess their developmental outcome.
