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Outcome of extreme prematurity: as information increases so do the dilemmas
  1. J L Watts,
  2. S Saigal
  1. Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
  1. Correspondence to:
    Professor Watts
    Department of Pediatrics, McMaster University, 1200 Main St W, HSC-3N27, Hamilton, Ontario L8S 4J9, Canada; wattsj{at}


Application of technology in neonatal intensive care has been very successful in reducing mortality, particularly in extremely low birthweight infants. As survival has improved, the need for accurate studies of long term outcome has increased. This need has been met by studies that are larger, more inclusive, and address a wider variety of later outcomes. Rather than a comprehensive quantitative review of these studies, this article uses a smaller number of studies that focus on infants of borderline viability, to illustrate current dilemmas and challenges in interpretation, and the actions, both individual and societal, that may be prompted by these interpretations.

  • ADHD, attention deficit/hyperactivity disorder
  • ELBW, extremely low birthweight
  • IQ, intelligence quotient
  • VLBW, very low birthweight
  • extremely low birthweight infant
  • mortality
  • developmental disability
  • follow up
  • decision making

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  • Competing interests: none declared