Decreases in infant mortality rates in the United States reflect the success of sustaining the lives of increasingly more immature infants. This success generates abiding concern about the outcomes of these infants, and that concern has led to a large number of publications on the outcomes of very low birth weight ([VLBW] <1500 g) infants. The extent to which this experience provides results useful for clinical and policy decisions is less clear. Three major concerns are identified. The first is that the research question underlying many studies is framed imprecisely, and may be addressed with inappropriate study design and outcomes. Moreover, the underlying causal pathway is rarely specified. Second, the current focus of most studies is on a relatively narrow range of neurodevelopmental and cognitive outcomes and fails to capture significant nonneurologic morbidity. Moreover, the ways in which even the neurodevelopmental outcomes are reported provide little guidance to clinicians or...

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