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It is important to determine if rates of survival and major neurodevelopmental impairment in extremely low gestational age newborns (ELGANs; infants born at 23-27 weeks gestation) are changing over time. Methods: Study infants were born at 23 to 27 weeks of gestation without congenital anomalies at a tertiary medical center between July 1, 1990 and June 30, 2000, to mothers residing in a thirteencounty region in North Carolina. Outcomes at one year adjusted age were compared for two epochs of birth: epochdoi:10.1186/1471-2431-7-20 pmid:17477872 pmcid:PMC1876228 fatcat:eamvuv35qbcz3h7srlh535t77u