European Consensus Guidelines (ECG) on the management of respiratory distress syndrome (RDS) have been developed and updated twice since 2007 reflecting changes in practice as new evidence emerges. The aim of this study was to evaluate the progress in clinical outcome of babies after the implementation of the updated ECG in 2010. Forty-eight neonates born in 2002-2003 (Group 02/03; n = 15) and in 2012-2013 (Group 12/13; n = 33) at gestational age of 26.2 ± 1.7 weeks were included into this retrospective study. Resuscitation procedures, ventilation support, and postnatal administration of surfactant were assessed. In Group 12/13, compared with Group 02/03, there was a higher rate of maternal corticosteroid prophylactic treatment (33 % vs. 0 %, p < 0.001), more children received primary nasal continuous positive airway pressure (nCPAP) (54.5 % vs. 20 %, p < 0.01) and repeated doses of surfactant (33 % vs. 0 %, p < 0.001), and had a reduced rate of mortality, bronchopulmonary dysplasia, and necrotizing enterocolitis. We conclude that the management of extremely preterm newborns improved considerably over the decade resulting in a significant reduction of mortality and morbidity.

Late preterm neonates show similar progressive postnatal increase in blood flow velocities accompanied with a decrease in vascular resistance in SMA and TC then term neonates.

Important changes occur in splanchnic circulation during the first 6 h after birth. The rise in end-diastolic velocity in the superior mesenteric artery from negative to positive values in 83% of healthy term newborns is the most important change.

A b s t r a c t Significant hemodynamic changes happen in the abdominal region at the moment of birth and during the first week of life in premature newborns. The aim of the study was to assess early postnatal changes of Doppler sonographic blood flow parameters in the superior mesenteric artery (SMA) occurring during the first three days of life in late preterm infants. 10 infants were enrolled into the prospective study. Abdominal blood flow velocities (ABFV) in the SMA were obtained at the age of 2, 24 and 72 hours (h), before feeding. Screening parameters included the peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged mean velocity (TAMV). Doppler indices (DI) -resistance index (RI) and pulsatility index (PI) were calculated. EDV changed significantly from 2 h to 24 h [-13.08 cm/s (-20.46 --9.34) to 12.79 cm/s (11.83 -24.72); p < 0.01] with a further statistically insignificant increase within 72 h [12.79 cm/s (11.83 -24.72) to 17.90 cm/s (16.93 -19.25)]. The EDV values were negative in 9 out of l0 neonates at 2 h of age. The SMA PSV showed a daily increase from 2 h to 72 h. The ABFV and characteristics of vascular resistance (DI) in the SMA change significantly in near term infants within the first 3 days. At 2 h of age a negative blood flow and elevated parameters characterizing vascular resistance were documented in the superior mesenteric artery.

AbstractsResults A total of 5565 births were included in the EPIPAGE 2 study: 1752 were born extremely preterm (898 (51%) stillbirths and 854 (49%) live births), 2728 very preterm (298 (11%) stillbirths and 2430 (89%) live births), and 1085 moderately preterm (28 (2.5%) stillbirths and 1057 (97.5%) live births). The survival rates for extremely preterm babies were 23% of all births and 48% of live births. The corresponding survival rates were respectively 83% and 93% at 27-31 weeks and 96% and 99% at 32-34 weeks. In 1997 (EPIPAGE 1 study), the survival rates were 20% of all births and 46% of live births at 22-26 weeks and 76% of all births and 88% of live births at 27-31 weeks. Conclusion Survival has improved among very preterm children, but has not changed at extremely low gestational ages. ALTERED FRONTO-TEMPORAL NEUROANATOMY IN VERY PRETERM BORN ADULTS DURING COMPLETION OF Centro de Investigaciones Medico-Sanitarias (CIMES), C/Marques de Beccaria 3, Malaga, SpainBackground and aims Several studies have described poorer cognitive performance in various aspects of language such as comprehension, naming, expressive language and verbal fluency in individuals who were born very preterm compared to controls. Neuroimaging investigations have also described structural and functional changes that could underlie such language deficits. In this pilot study we used functional MRI to explore whether alterations in the neuroanatomy of phonological verbal fluency persisted into adulthood following very preterm birth. Methods Twenty-two young adults (26-28 years old, females=11, males=11) were examined. Eleven individuals were born very preterm (gestational age: < 33 weeks) and 11 were full-term born controls. All participants underwent functional MRI using a 3T scanner while completing a phonological verbal fluency task. All data pre-and postprocessing was performed using FSL (www.fmrib.ox.ac.uk/fsl). Results During successful verbal fluency trials, very pretermborn individuals showed significantly decreased blood-oxygenlevel-dependent signal compared to controls in several brain areas including the orbitofrontal/medial frontal cortex bilaterally (x=8mm, y=52mm, z= -28mm) and the left fusiform/parahippocampal gyrus (x= -34mm, y= -30mm, z= -24mm), p<0.05 family wise-error corrected (FWE). On-line performance did not significantly differ between the groups. Conclusions Previous studies with functional MRI in younger samples have shown neuroanatomical alterations (increased and decreased activation) in fronto-temporal and fronto-striatal networks in very preterm born individuals when performing different cognitive tasks. Our results suggest that neuroanatomical alterations during language processing persist into adult life following very pre-term birth, and specifically involve fronto-temporal networks, with important implications for a wide range of high order cognitive functions.