Background

Background

In recent years, major progress has been made in the management of pregnancies with a risk of premature birth and in care of very premature babies. Survival rates for extremely premature babies have improved substantially and most of the surviving children are free from serious disabilities. Unfortunately, some children who survive later experience problems with learning, memory, reading and writing and motor function.

Care at birth for extremely premature babies is very resource-intensive and staff and parents are often faced with difficult ethical decisions. The methods used in the care of very premature babies are usually evaluated on older children. This means that there is no definite evidence for what care is best for the child, both before and after birth. There is therefore a need for studies and research on premature babies.

Twenty years ago, a Swedish study was carried out that registered data on all children with a birth weight of less than 1000 grams (the 1000 gram study). The results of the study provided very valuable information and had practical consequences, for example the study showed that children born at a university hospital with a neonatal intensive care unit had a higher chance of survival than children born at a smaller hospital.

The rapid developments in obstetrics, and especially in neonatology, mean that many of the findings of the “1000 gram study” are no longer valid. For instance, more children are now surviving the very early weeks of pregnancy. Health care staff have a new group of premature babies to take care of, ‘the new survivors’.