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Abstract
Survival rates have greatly improved in recent years for infants of borderline viability;
however, these infants remain at risk of developing a wide array of complications,
not only in the neonatal unit, but also in the long term. Morbidity is inversely related
to gestational age; however, there is no gestational age, including term, that is
wholly exempt. Neurodevelopmental disabilities and recurrent health problems take
a toll in early childhood. Subsequently hidden disabilities such as school difficulties
and behavioural problems become apparent and persist into adolescence. Reassuringly,
however, most children born very preterm adjust remarkably well during their transition
into adulthood. Because mortality rates have fallen, the focus for perinatal interventions
is to develop strategies to reduce long-term morbidity, especially the prevention
of brain injury and abnormal brain development. In addition, follow-up to middle age
and beyond is warranted to identify the risks, especially for cardiovascular and metabolic
disorders that are likely to be experienced by preterm survivors.