The purpose of this observational study was to determine whether there has been a significant increase in the use of surfactant, low dose prophylactic indomethacin (LDPI) and antenatal steroids between 1989-1992 and 1994-1995 at Women and Infant's Hospital (WIH), Providence, RI, and to determine whether the increased use of these interventions will decrease neonatal mortality, the incidence of intraventricular hemorrhage (IVH) and patent ductus arteriosus(PDA) among the very low birth weight infants (VLBW). We reviewed the maternal and infants' medical records of 78 infants born between 10/94 - 6/95 with birth weight of 600 gm - 1250 gm without significant congenital anomalies. For the 1989-1992 period, data for 110 infants were obtained from the WIH placebo group of the multicenter trial to evaluate LDPI (Ment et alPediatrics, 93: 543, 1994). When compared to 1989-1992, there was a significant increase in the use of antenatal steroids (30% vs 52%, p = 0.004) and LDPI (0 vs 91%, p = < 0.001). There was no difference in the use of surfactant. The following table is a comparison of various morbidities between two study periods. Conclusion: The results of a clinical trial has altered the practice behavior of the Perinatal Center involved in the study. Although there was a trend toward less death and IVH, the increased use of LDPI and ANS did not statistically reduce the mortality and IVH, but showed a significant decrease in the incidence of PDA requiring therapy during the first five days of life.

Table 1
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