A new study shows improved survival among infants born extremely early (before 25 weeks), thanks in part to more consistent application of some advanced therapies such as surfactant, a substance that helps prevent the air sacs in the lungs of preemies from collapsing.

Dr. Susan R. Hintz, from Stanford University, Palo Alto, California and colleagues analyzed data on 1,408 infants born during 1991 and1994 at less than 25 weeks estimated gestational age. They weighed from 500 to 1500 grams. These were compared with 1,348 similar infants born during 1995 and 1998.

Death was significantly higher in the earlier than the later group - 63 percent versus 56 percent. Those in the later group received steroids, antibiotics, and surfactant significantly more often than did the other infants.

“There was quite a difference between the two groups in the application of those therapies, which are pretty much standard of care now,” Hintz told Reuters Health. “Even though surfactant was available in 1991, it was not being applied as consistently,” she said.

However, despite the improved survival of infants with more consistent application of advanced therapies, illnesses in extremely preterm infants increased from the first to the second time period.

“This,” Hintz concluded, “could mean that the resulting surviving population may be a higher risk population that is going to be at higher risk for these major in-hospital (illnesses).”

The study findings appear in the March issue of the journal Archives of Diseases of Childhood Fetal Neonatal Edition.

SOURCE: Archives of Diseases of Childhood - Fetal Neonatal Edition, March 2005.