The care of critically ill VLBW infants continues to change. The data base in the Neonatal Research Network (NRN) involving 5 neonatal centers provides an excellent opportunity of analyzing the trends over time in treatment and outcome measures including neonatal mortality rate (NMR) and selected morbidities for VLBW (BW 501-1500gm) infants. Over the seven-year period, there has been a gradual and significant decline in NMR in VLBW infants(P<.001). Declines were observed in all 250 gm intervals: from 1988 to 1994, NMR declined from 58.9% to 43.3% for 501 - 750 gm, 28.3% to 12.5% for 750 - 1000 gm, 11.3% to 4.9% for 1001 - 1250 gm and 7.0% to 3.8% for 1251 - 1500 gm groups, respectively. While the incidence of mild intraventricular hemorrhage (IVH, Gr I & II) was unchanged, severe IVH (Gr III & IV) declined significantly over time. There has been a significant increase in the usage of two perinatal interventions: antenatal steroid (ANS) and surfactant replacement therapy with documented improvement in outcomes. No difference in the incidence of chronic lung disease and necrotizing entrocolitis was observed. We conclude that mortality and severe IVH in the VLBW infants in the NRN Centers have declined significantly over the past seven years. These data may be useful in counseling parents and in bench-marking the clinical performance of a neonatal center. Table

Table 1
Full size table