With full contemporary neonatal intensive care, the outcome for liveborn infants in the present cohort delivered following membrane rupture occurring before 24 weeks' gestation, of at least 14 days duration, was better than previously reported.

To describe mortality and neurodevelopmental outcome before and after the introduction of rescue therapy with natural surfactant in two neonatal units in Toronto, Canada, a retrospective cohort study of 891 liveborn 23–26 wk gestational age infants, 421 presurfactant (1982–1987) and 470 postsurfactant (1990–1994) was performed. Overall mortality was stable over time (41% vs 35%, p = 0.077), but declined for inborn 24 (71% vs 43%, p = 0.03) and 26 wk (26% vs 13%, p = 0.01) gestational age infants and was higher in surfactant‐treated infants (p > 0.0001). Chronic lung disease (61% vs 34%, p > 0.0001) and bilateral blindness (8% vs 4%, p = 0.004) declined over time, with stable rates of cerebral palsy (12% vs 15%), cognitive deficit (27% vs 26%) and aided sensorineural hearing loss (5% vs 4%). Sixty‐five percent of surviving infants in both eras were free from neurodevelopmental impairment, and severe impairment declined over time (p = 0.035). This study shows no secular change in overall mortality in a large cohort of 23–26 wk gestational age infants since the introduction of rescue therapy with natural surfactant. However, it does suggest that maternal transfer to and delivery of all extremely preterm infants in high risk perinatal centres is justified.

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Arch Dis Child 2012;97(Suppl 2):A1-A539 A101 Abstracts 2011. Exclusion criteria were presence of major congenital malformation, metabolism inborn errors, chromosomal anomalies. Adiponectin and leptin cord blood levels were determined by ELISA kits (R&D Systems). Results Included 127 newborns: 55 VLBW preterm and 72 term newborns. There were no statistical differences regarding maternal gestational diabetes, urinary tract infection, age and BMI. Adiponectin levels were significantly higher in term than in preterm newborns: 2.4±0.22pg/ml versus 1.57±0.74 pg/ml (p<0.001), respectively; leptin levels were similar in both groups: 1.25 ±0.90pg/ ml and 1.38 ±0.99pg/ml (p=0.481), respectively. Despite being adequate or small for gestational age, VLBW preterm newborns showed lower levels of adiponectin than term newborns (p<0.001), and there were no statistically significant differences for leptin levels. In the linear regression, prematurity was the only independent variable associated to low levels of adiponectin (p<0.001). Conclusion Prematurity is the main determinant factor for lower adiponectin levels in umbilical cord blood of newborns. Introduction Human milk (HM) contains antioxidant enzymes such as superoxide dismutase (SOD), glutathione peroxidase (GSHPx) and catalase. Melatonin (MT) shows antioxidative properties both directly by stimulating the activities of antioxidant enzymes and indirectly by scavenging free radicals. The aim of this study was to evaluate the effect of MT status on the level of SOD, GSH-Px 3 and the total antioxidant capacity (TAC) of HM. Material and Methods 114 samples of HM were collected from 22 healthy women during daytime (DT; 10a.m.-9.59p.m.) and nighttime (NT; 10p.m.-9.59a.m.). MT, SOD, GSH-Px3 levels and TAC were assayed and compared between DT-HM and NT-HM. Moreover, the Pearson's correlation coefficient was calculated between MT and SOD, GSH-Px3 and TAC. Results MT showed a circadian rhythm with high levels at NT and low levels at DT (mean± SEM; 9.2±1.2 vs. 2.0±0.3 pg/ml, respectively, p<0.0001), while SOD, GSH-Px3 and TAC had no circadian changes in HM (p>0.05). There was no correlation between MT levels and SOD, GSH-Px3 levels and TAC. Conclusion The MT status influence neither SOD and GSH-Px3 levels nor TAC of HM. It should be pointed that our results represent only the effect of MT on the extracellular component of the antioxidant system and it does not exclude the possibility that high MT concentrations in HM may induce the intracellular and mitochondrial antioxidant enzyme system in the gastrointestinal tract. ANALYSIS OF ANTIOXIDATIVE STATUS OF HUMAN MILK AND ITS VARIATIONS AT DAY AND NIGHT TIME