The cost of saving smaller lives

Having a preterm infant is an understandable fear for many pregnant women, especially those who have experienced, first hand, the roller-coaster ride of an infant’s stay in a neonatal intensive care unit. 

Certainly, there have been a number of changes over the 50 years since neo­natal intensive care management began.

Developments in the field include improved obstetric diagnostic and interventional abilities, the use of antenatal corticosteroids to mature preterm lungs, the use of intravenous salbutamol to suppress labour, the evolution of neo­natal ventilators, exogenous surfactant therapy for respiratory distress syndrome, the restriction of supplemental oxygen to minimise the risk of retinopathy, better nutrition and, of course, concentrated nursing and medical expertise. 

But many may ask whether the improvements in medical care of extremely low gestational age infants have translated into better outcomes for those