Improvement in mortality of very low birthweight infants and the changing pattern of neonatal mortality: the 50-year experience of one perinatal centre.

AIM: Neonatology is a relatively new sub-specialty so we aimed to review survival data in the context of advances in neonatal care.

METHOD: Review of neonatal survival for very low birthweight babies over the last 50 years.

RESULTS: In the data collected from a single tertiary neonatal unit, survival for babies 501-1000 g improved from below 10% in 1959 to over 60% in 2009. Similarly, survival for babies 1001 to 1500 g has improved from approximately 50% to over 90%. During the study period, death due to extreme prematurity or cardiorespiratory problems, namely respiratory distress syndrome, fell from 90% in 1964 to only 45% of neonatal deaths in 2008.

CONCLUSION: In addition to reporting the remarkable improvement in neonatal survival over this period, we have highlighted items of historical context.