The very preterm (VPT) (<32 weeks' gestational age) growth-restricted fetus confronts several problems more frequently than does the VPT fetus who is not growth-restricted. One of those problems is higher fetal and neonatal mortality rates, in part because fewer VPT growth-restricted fetuses are offered perinatal intensive care. The other problem is higher rates of neurologic or cognitive deficits in those who survive in some,2,–,4  but not all, studies. Two reports in this issue of Pediatrics provide additional data on these problems for the VPT growth-restricted fetus.6,7  In a follow-up study at school age of a complete geographic cohort of live births (in 1997) at 24 to 32 completed weeks' gestation from 9 regions in France, Guellec et al reported that mortality rates were higher in those born at the <10th centile and that some cognitive, behavioral, and academic deficits...

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