{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:36Z","timestamp":1791331236880,"version":"4.3.1"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,3,1]]},"abstract":"<jats:p>Context. Although individual components of neonatal intensive care have proven efficacy, doubts remain about its overall effectiveness.<\/jats:p><jats:p>Objective. To determine the changes in effectiveness of neonatal intensive care for extremely low birth weight (ELBW) infants over 2 decades.<\/jats:p><jats:p>Design. Population-based cohort study of consecutive ELBW infants born during 4 distinct eras: 1979\u20131980, 1985\u20131987, 1991\u20131992, and 1997, all followed to at least 2 years of age.<\/jats:p><jats:p>Setting. The state of Victoria, Australia.<\/jats:p><jats:p>Patients. All ELBW live births of birth weight 500 to 999 g in the state in the calendar years indicated (1979\u20131980 [n = 351]; 1985\u20131987 [n = 560]; 1991\u20131992 [n = 429]; 1997 [n = 233]). Survivors were assessed at 2 years of age by pediatricians and psychologists blinded to perinatal details. The follow-up rates were high for each ELBW cohort (1979\u20131980: 100% [89 of 89]; 1985\u20131987: 100% [212 of 212]; 1991\u20131992: 98% [237 of 241]; 1997: 99% [168 of 170]).<\/jats:p><jats:p>Main Outcome Measures. Survival and quality-adjusted survival rates at 2 years of age.<\/jats:p><jats:p>Results. The survival rate to 2 years of age improved significantly between successive eras (absolute increase and 95% confidence interval: 1985\u20131987 vs 1979\u20131980, 12.5% and 6.3%\u201318.4%; 1991\u20131992 vs 1985\u20131987, 18.3% and 12.1%\u201324.4%; 1997 vs 1991\u20131992, 16.8% and 9.2%\u201323.9%), as did the quality-adjusted survival rate (absolute increase: 1985\u20131987 vs 1979\u20131980, 12.4%; 1991\u20131992 vs 1985\u20131987, 13.8%; 1997 vs 1991\u20131992, 13.2%). Overall, the survival rate increased from \u223c1 in 4 (25%) in 1979\u20131980 to 3 in 4 (73%) in 1997, and the quality-adjusted survival rate also increased threefold, from 19% in 1979\u20131980 to 59% in 1997. The biggest gains in survival and quality-adjusted survival in the most recent era were in infants in lighter birth-weight subgroups.<\/jats:p><jats:p>Conclusion. The effectiveness of neonatal intensive care for ELBW infants in Victoria improved progressively from the late 1970s to the late 1990s.<\/jats:p>","DOI":"10.1542\/peds.113.3.505","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:53:04Z","timestamp":1092444784000},"page":"505-509","source":"Crossref","is-referenced-by-count":134,"title":["Evaluation of Neonatal Intensive Care for Extremely Low Birth Weight Infants in Victoria Over Two Decades: I. Effectiveness"],"prefix":"10.1542","volume":"113","author":[{"given":"Lex W.","family":"Doyle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Victorian Infant Collaborative Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2004,3,1]]},"reference":[{"key":"2021121006104215400_R1","doi-asserted-by":"crossref","unstructured":"Sinclair JC, Torrance GW, Boyle MH, Horwood SP, Saigal S, Sackett DL. Evaluation of neonatal-intensive-care programs. N Engl J Med.1981;305:489\u2013494","DOI":"10.1056\/NEJM198108273050904"},{"key":"2021121006104215400_R2","unstructured":"The Consultative Council on Obstetric and Paediatric Mortality and Morbidity. Annual Report for the Year 1997, Incorporating the 36th Survey of Perinatal Deaths in Victoria. 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