Published 22 June 2009, doi:10.1136/bmj.b2325
Cite this as: BMJ 2009;338:b2325

Clinical Review

The extremely premature neonate: anticipating and managing care

Natalie K Yeaney, consultant in neonatology1, Edile M Murdoch, consultant in neonatology1, Christoph C Lees, consultant in obstetrics and fetal-maternal medicine2

1 Department of Neonatology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 2QQ, 2 Department of Fetal-Maternal Medicine, Addenbrooke’s Hospital

Correspondence to: C Lees christoph.lees@addenbrookes.nhs.uk

The first 150 words of the full text of this article appear below.


Improvements in neonatal care mean that many extremely preterm infants now survive, but neurodevelopmental and other morbidities are common
The incidence of extremely preterm birth is increasing
Survival rates improve greatly with each week of gestation
The use of antenatal corticosteroids and the baby’s sex, birth weight, and condition at delivery affect survival and should inform decisions about resuscitation
Guidelines can aid the clinician at delivery, but detailed discussions with parents, obstetricians, and neonatologists should be undertaken, ideally before delivery
Sustained support of families is essential
Prevention is the best way to limit the mortality and morbidity associated with extreme prematurity


Preterm deliveries are increasing in absolute numbers and as a proportion of all births. According to NHS data for England in 2006, 2000 births—0.3% of all births—were extremely preterm (23-25+6 weeks’ gestation).1 Similar numbers are reported by other western European countries. Preterm births have increased by 20% over the . . . [Full text of this article]


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Rapid Responses:

Read all Rapid Responses

Anticipate the need for physiological transition in extremely preterm babies
David JR Hutchon
bmj.com, 11 Jul 2009 [Full text]
Authors' response
Christoph C Lees, et al.
bmj.com, 20 Jul 2009 [Full text]
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