Dear Colleagues,

Over the last 10–20 years, there have been significant gains in the care of preterm infants at less than 30 weeks of gestation. We have been able to improve our skill set in the fields of respiratory and hemodynamic management so that neonatal morbidity is steadily declining in overall incidence for preterm infants, particularly in infants at 28–29 weeks of gestation. As we become more proficient in the care of these infants, we begin to translate these skill sets for the more extreme preterm infants, those at <26 weeks of gestation but most importantly the infants born below 24 weeks of gestation. These infants are not only preterm but are also physiologically immature, which adds a dimension in their care and ultimate survival. It is now important to share how we can optimize survival but also ensure that there are positive outcomes both in neonatal morbidities and neurodevelopmental outcomes. How these very extreme preterm infants traverse the neonatal pathways will play a significant role in how they are able to develop as a functioning child. The traditional outcomes of death, cerebral palsy, vision and hearing deficits, and cognitive deficits may not be adequate in evaluating how these extreme preterm infants present post-discharge. We need to go beyond theses traditional outcomes and look at functional outcomes as we explore our ongoing approaches in care. In addition, we need to explore how parents use coping skills in the 20–30 weeks of neonatal care their infants may have.

I hope that this Special Issue will be an opportunity to look at how we can optimize care for these infants and their parents.

Dr. Elizabeth Asztalos
Guest Editor

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• extreme prematurity
• neonatal morbidities
• ventilatory management
• nutrition
• developmental care
• parental care
• functional neurodevelopmental outcomes
• family impact and stress