Survival and later morbidity after extremely preterm birth are key issues to factor into the care of women and their children at borderline viability. Whereas we have robustly collected information on survival that shows some increases at 24–25 weeks of gestation, few data suggest any change in morbidity. Of babies born before 26 weeks of gestation around one quarter grow up with serious disability. Mild disabilities are common amongst the remainder. Overwhelmingly the major adverse outcome following extremely preterm birth is cognitive impairment, something that may not be apparent until school age, when we make increasing demands on children to perform. Despite these problems studies of very preterm/very low birthweight children as adults seem to indicate good adaptation and integration into society.
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