The Smallest Preterm Infants: Reasons for Optimism and New Dilemmas

Arch Pediatr Adolesc Med -- Classics in Pediatrics: The Smallest Preterm Infants: Reasons for Optimism and New Dilemmas, August 2011, Baker 165 (8): 689: "Although costs for the smallest infants . . . have been considerably higher, significant advances in management—notably surfactant therapy and greater use of antenatal steroids—have greatly improved outcomes for most premature infants. One can argue that neonatology has become more efficacious since the 1970s and that costs have not risen as much as might have been expected. Unfortunately, the rate of preterm birth (specifically, that pertaining to infants between 32 and 36 weeks' gestation) has increased since the 1970s, a trend that has run contrary to expectations. A variety of factors, including fertility treatments and the willingness of obstetricians to induce deliveries earlier, may be involved. . . . Since the 1970s, neonatal medicine has succeeded to a remarkable degree in both saving the lives of ever-smaller premature infants and doing so with fewer complications.