Abstract 213

We analyzed demographic, diagnostic and treatment data from the 718 extremely low BW (ELBW) neonates (BW<1001 gm) who were admitted to out intensive care nursery during the 9 years from 1989-97. From the first three years to the last three years during this period, there were increases in survival (62 to 76%), surfactant use (25% to 91%), BMETH (8% to 55%), Mg tocolysis (15% to 44%), and dexamethasone use (27% to 46%), an increase in retinopathy of prematurity (ROP, stage 3 or 4, 9% to 40%) and a decrease in intraventricular hemorrhage (grade III or IV, 40% to 25%). All changes were significant at p<.05 by chi-square analysis using 3-yr time blocks. There were no changes over time in any of the other study variables (BW, bronchopulmonary dysplasia, sepsis, Caesarian delivery, patent ductus arteriosus, hospital of birth, indomethacin use or cryotherapy for ROP). Among surfactant, BMETH, and Mg treatments, only BMETH use was statistically associated with survival (p<.01, Mantel-Haenszel analysis) when controlling for BW, year and the other two variables. These data stress the importance of prenatal BMETH for the survival of the ELBW. The lack of significance for surfactant use is most likely the result of almost 100% use of this treatment during two of the three time strata and should not be taken as evidence against surfactant use.