Individuals born extremely preterm (before 28 weeks of gestation) comprise only about 0.7% of births in the United States and an even lower proportion in other high resource countries. However, these individuals account for a disproportionate number of children with cerebral palsy, intellectual deficit, autism spectrum disorder, attention deficit hyperactivity disorder, and epilepsy. This review describes two large multiple center cohorts comprised of individuals born extremely preterm: the EPICURE cohort, recruited 1995 in the United Kingdom and the Republic of Ireland, and the Extremely Low Gestational Age Newborn (ELGAN), recruited 2002–2004 in five states in the United States. The primary focus of these studies has been neurodevelopmental disorders, but also of interest are growth, respiratory illness, and parent- and self-reported global health and well-being. Both of these studies indicate that among individuals born extremely preterm the risks of most neurodevelopmental disorders are increased. Early life factors that contribute to this risk include perinatal brain damage, some of which can be identified using neonatal head ultrasound, bronchopulmonary dysplasia, and neonatal systemic inflammation. Prenatal factors, particularly the family's socioeconomic position, also appear to contribute to risk. For most adverse outcomes, the risk is higher in males. Young adults born extremely preterm who have neurodevelopmental impairment, as compared to those without such impairment, rate their quality of life lower. However, young adults born extremely preterm who do not have neurodevelopmental impairments rate their quality of life as being similar to that of young adults born at term. Finally, we summarize the current state of interventions designed to improve the life course of extremely premature infants, with particular focus on efforts to prevent premature birth and on postnatal efforts to prevent adverse neurodevelopmental outcomes

在美国，极早产儿（妊娠 28 周之前）仅占新生儿的 0.7% 左右，而在其他资源丰富的国家，这一比例甚至更低。然而，这些人在患有脑瘫、智力缺陷、自闭症谱系障碍、注意力缺陷多动障碍和癫痫的儿童中所占的比例过高。这篇综述描述了两个由极度早产个体组成的大型多中心队列：EPICURE队列，1995年在英国和爱尔兰共和国招募，以及极低胎龄新生儿（ELGAN），2002-2004年在美国五个州招募。美国。这些研究的主要焦点是神经发育障碍，但也令人感兴趣的是生长、呼吸系统疾病以及父母和自我报告的全球健康和福祉。这两项研究都表明，在极度早产的个体中，大多数神经发育障碍的风险都会增加。导致这种风险的早期生活因素包括围产期脑损伤，其中一些可以通过新生儿头部超声、支气管肺发育不良和新生儿全身炎症来识别。产前因素，特别是家庭的社会经济地位，似乎也会导致风险。对于大多数不良结果，男性的风险较高。与没有神经发育障碍的人相比，严重早产的年轻人的生活质量较低。然而，没有神经发育障碍的极度早产年轻人的生活质量与足月出生的年轻人相似。最后，我们总结了旨在改善极早产儿生命历程的干预措施的现状，特别关注预防早产的努力和产后预防不良神经发育结果的努力