Decreased incidence of neurologic disability among neonates at high risk born between 1975 and 1984 in Alberta.

We report the outcome at 2 or 3.5 years of 1463 neonates at high risk born between 1975 and 1984 and cared for in a regional perinatal program in Alberta. Although the number of surviving infants of very low birth weight (1250 g or less) increased over the study period, the incidence rate of neurologic impairment fell significantly, from 19% to 13% (p less than 0.01), so that there was no significant increase in the absolute number of disabled children. This finding remained valid when two other groups of infants at high risk (those weighing more than 1250 g at birth and having a positive neurologic history and those born at term with asphyxial encephalopathy) were included in the analysis, so that over the decade there was a significant decrease in the incidence of disability among the total group of neonates (p less than 0.01) and no increase in the absolute number of disabled children (23 in 1975 and 19 in 1984). We conclude that neonatal intensive care has contributed to improved survival of neonates at high risk without increasing the burden of major neurologic disability.