Background: In the last two decades the Dutch policy towards the limits of viability has been modified twice: 2006 (active treatment from 26 to 25 weeksu2019 gestation) and 2010 (active treatment from 25 to 24 weeksu2019 gestation). Knowledge concerning the effect of these guideline changes on neonatal outcome is limited. The aim is to evaluate early neonatal outcome in in infants born below 29 weeksu2019 gestation in one of the ten tertiary perinatal centres in the Netherlands.Methods:Study population: retrospective, single-center cohort study of all live- and stillborn infants born <29 weeksu2019 gestation at Mu00e1xima Medical Center Veldhoven between 2006-2016. One-year survival rate was evaluated and complication rates were calculated relative to infants born alive and infants alive at 36 weeksu2019 postmenstrual age (serious brain lesion: grade u2265III intraventricular hemorrhage or cystic periventricular leukomalacia; necrotizing enterocolitis stage 2-3; oxygen need >21% at 28 days, as a proxy of bronchopulmonary dysplasia; laser therapy or surgery for retinopathy of prematurity.Results:844 preterm infants were included (table 1). One-year survival rate of live born infants demonstrates an increase in one-year survival for infants born at 24 (0% to 63%) and 25 (59 to 79%) weeksu2019 gestation (figure 1). Overall, prematurity related morbidity rates are decreasing with increasing gestational age (table 2). Figure 2 shows no substantial differences in complications over time.Conclusion:With the changing policy in neonatal care, survival of as improved considerably extremely preterm infants in the last decade without significant changes in neonatal complications. Further studies are required to evaluate the effects on long-term outcomes.