best strategies against respiratory problems in extremely low birth weight infants

background neonatology has evolved with respect to the needs of premature infants for special care. one of the major problems in premature infants is that their lungs are not developed adequately to fulfill newborns’ needs. there is a broad spectrum of strategies for management of respiratory problems in premature infants. in this study, we aimed to determine the best strategies against respiratory problems in extremely low birth weight infants. materials and methods  in this analytical, prospective study, we recruited 79 newborns with birth weight of less than 1000 g, who were born in mahdieh hospital in tehran- iran, during september 2011-march 2013. the newborns were divided into three groups of supportive care (n=10), the insure strategy (n=17), and mechanical ventilation (n=52) based on their needs. survival rate and complications were evaluated among these groups. results gestational age ranged between 23 and 34 weeks, and birth weight ranged between 420g and 1000 g. survival rates in the supportive care, insure, mechanical ventilation groups were 90%, 47.1%, and 17.3%, respectively. gestational age and birth weight in the three groups were significantly different (p<0.05). complications were not significantly different between the groups except for pulmonary hemorrhage, which was significantly higher in the mechanical ventilation group, compared to the other groups (p<0.05). conclusion   however weight and gestational age are significantly different in all three groups, but only pulmonary hemorrhage as biomedical variable was higher in mechanical ventilation group. the best strategy according to different conditions for challenging babies is intervention only when it would be necessary and not rushing in insure and mechanical ventilation.