In view of the increased survival rate of very preterm neonates, several longitudinal studies were done to assess the quality of life of the survivors. They revealed a fairly constant rate of 25-30% of sensorineural and/or motor impairment. Beyond those "major handicaps," further problems may arise in every single period of life, which, albeit less severe, add to the burden of prematurity. These include growth retardation and cognitive delay in the school age, affected psychosocial behavior during adolescence, and the "metabolic syndrome" of formerly malnourished fetuses in adulthood. Thus, the epidemiologic studies not only confirmed the role of regionalization in the quality of perinatology, but also supported a more farsighted approach to the sequelae of prematurity. Like in young adults who grew up with congenital heart defects, also in former preterm neonates, appropriate medical care has to be provided for an increasing number of long-term survivors. Moreover, the life-long effects of metabolic imprinting in growth-retarded fetuses underline the primary-preventive role of perinatal medicine, extending far beyond the "baby" stage of human development.
