The recent summary of a workshop held by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the Society for Maternal–Fetal Medicine, the AAP, and the ACOG on extremely preterm birth suggests that variation in reported outcomes may, in part, reflect differences in hospital practices regarding the initiation of either active treatment or comfort care. To investigate this possibility and its implications, we analyzed data collected for infants who were born at hospitals included in the NICHD Neonatal Research Network (NRN) to identify variation in hospital rates of active treatment and the relationship between active treatment and outcomes at 18 to 22 months of corrected age.


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