{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T06:45:32Z","timestamp":1789973132051,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2007,1,2]],"date-time":"2007-01-02T00:00:00Z","timestamp":1167696000000},"content-version":"vor","delay-in-days":2345,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2000,8]]},"abstract":"<jats:p>To describe mortality and neurodevelopmental outcome before and after the introduction of rescue therapy with natural surfactant in two neonatal units in Toronto, Canada, a retrospective cohort study of 891 liveborn 23\u201326 wk gestational age infants, 421 presurfactant (1982\u20131987) and 470 postsurfactant (1990\u20131994) was performed. Overall mortality was stable over time (41% vs 35%, <jats:italic>p =<\/jats:italic> 0.077), but declined for inborn 24 (71% vs 43%, <jats:italic>p =<\/jats:italic> 0.03) and 26 wk (26% vs 13%, <jats:italic>p =<\/jats:italic> 0.01) gestational age infants and was higher in surfactant\u2010treated infants (<jats:italic>p<\/jats:italic> &gt; 0.0001). Chronic lung disease (61% vs 34%, <jats:italic>p<\/jats:italic> &gt; 0.0001) and bilateral blindness (8% vs 4%, <jats:italic>p =<\/jats:italic> 0.004) declined over time, with stable rates of cerebral palsy (12% vs 15%), cognitive deficit (27% vs 26%) and aided sensorineural hearing loss (5% vs 4%). Sixty\u2010five percent of surviving infants in both eras were free from neurodevelopmental impairment, and severe impairment declined over time (<jats:italic>p =<\/jats:italic> 0.035).<\/jats:p><jats:p>This study shows no secular change in overall mortality in a large cohort of 23\u201326 wk gestational age infants since the introduction of rescue therapy with natural surfactant. However, it does suggest that maternal transfer to and delivery of all extremely preterm infants in high risk perinatal centres is justified.<\/jats:p>","DOI":"10.1111\/j.1651-2227.2000.tb00417.x","type":"journal-article","created":{"date-parts":[[2010,8,7]],"date-time":"2010-08-07T05:44:45Z","timestamp":1281159885000},"page":"959-965","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Outcome of infants 23\u201026 weeks' gestation pre and post surfactant"],"prefix":"10.1111","volume":"89","author":[{"given":"SE","family":"Jacobs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"O'Brien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Inwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EN","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HE","family":"Whyte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,1,2]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90645-5"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.66.7_Spec_No.765"},{"key":"e_1_2_1_4_2","first-page":"479","article-title":"Outcome of infants weighing less than 800 grams at birth: 15 years' experience","volume":"96","author":"Pine TR","year":"1995","journal-title":"Pediatrics"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70309-5"},{"key":"e_1_2_1_6_2","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1542\/peds.98.5.931","article-title":"Outcomes of extremely low birth weight infants","volume":"98","author":"Hack M","year":"1996","journal-title":"Pediatrics"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.314.7074.107"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.100.6.982"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.77.1.i91"},{"key":"e_1_2_1_10_2","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1542\/peds.92.3.447","article-title":"How aggressive should delivery room cardiopulmonary resuscitation be for extremely low birth weight neonates","volume":"92","author":"Davis DJ","year":"1993","journal-title":"Pediatrics"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)82015-3"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(93)90483-Y"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199303253281208"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199405263302102"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)90628-2"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.101.4.642"},{"key":"e_1_2_1_17_2","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1542\/peds.92.2.191","article-title":"Members of the National Institute of Child Health and Human Development Neonatal Research Network. Decreasing mortality associated with the introduction of surfactant therapy: an observational study of neonates weighing 601 to 1300 grams at birth","volume":"92","author":"Horbar JD","year":"1993","journal-title":"Pediatrics"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(94)70266-7"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02179667"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.1997.tb01021.x"},{"key":"e_1_2_1_21_2","first-page":"166","article-title":"Does surfactant therapy prolong dying? Age at in\u2010hospital death of extremely premature babies","volume":"16","author":"Coulter DM","year":"1996","journal-title":"J Perinatol"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199103283241301"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)82062-1"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)81226-0"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70012-9"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.65.7_Spec_No.667"},{"key":"e_1_2_1_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70003-X"},{"key":"e_1_2_1_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70008-0"},{"key":"e_1_2_1_29_2","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1542\/peds.82.4.543","article-title":"Two\u2010year follow\u2010up of infants enrolled in a randomized trial of surfactant replacement therapy for prevention of neonatal respiratory distress syndrome","volume":"82","author":"Dunn MS","year":"1988","journal-title":"Pediatrics"},{"key":"e_1_2_1_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02113261"},{"key":"e_1_2_1_31_2","first-page":"1","article-title":"Extreme immaturity: outcome of 568 pregnancies of 23\u2013 26 weeks' gestation","volume":"82","author":"Whyte HE","year":"1993","journal-title":"Obstet Gynecol"},{"key":"e_1_2_1_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(69)80224-6"},{"key":"e_1_2_1_33_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.82.4.527"},{"key":"e_1_2_1_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(78)80282-0"},{"key":"e_1_2_1_35_2","unstructured":"ParkerKC MainlandMK AmdurJR.DISC Preschool Screen Version 3.0; manual Kitchener\u2010Waterloo Hospital;1990"},{"key":"e_1_2_1_36_2","volume-title":"Bayley Scales of infant development","author":"Bayley N","year":"1969"},{"key":"e_1_2_1_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/0378-3782(96)81314-4"},{"key":"e_1_2_1_38_2","volume-title":"The Cochrane Library, Issue 2","author":"Soll R","year":"1999"},{"key":"e_1_2_1_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(94)70160-1"},{"key":"e_1_2_1_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(94)70161-X"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1651-2227.2000.tb00417.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1651-2227.2000.tb00417.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T11:53:50Z","timestamp":1698580430000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1651-2227.2000.tb00417.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,8]]},"references-count":39,"aliases":["10.1080\/080352500750043431"],"journal-issue":{"issue":"8","published-print":{"date-parts":[[2000,8]]}},"alternative-id":["10.1111\/j.1651-2227.2000.tb00417.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1651-2227.2000.tb00417.x","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,8]]},"assertion":[{"value":"2007-01-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}