Advances in obstetrical and neonatal care, with new technologies and therapies, such as surfactant, has improved infant outcomes over time. We examined the impact on VLBW infants by comparing the 2-year outcomes of infants born in the pre-surfactant era (Era A: 1984-1988) and the early surfactant era (Era B: 1989-1993) followed by our regional Perinatal Follow-up Program. The data represents all livebirths with BW 500-1499 grams from a defined geographic region in Nova Scotia, Canada.

RESULTS: There were no differences between the cohorts for BW, gestational age, mortality, vision and hearing at two years, and follow-up rate (95.6% vs 94.3%). Infants with BW 1000-1499 grams in Era B had statistically better 2-years corrected Bayley MDI scores. There was a decreased rate of cerebral palsy in Era B for infants with BW 1250-1499 grams, 1/104 vs 9/116 in Era A, p=0.044. Table

Table 1
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SUMMARY: There is improvement in long-term outcomes for the larger VLBW infants in Era B. We speculate that this improvement will be evident for the smaller VLBW infants with time and further advances in prenatal and neonatal care.