In recent years, neonatal mortality rates for low-birthweight infants have declined both in neonatal intensive care units and in several populations in the industrialized world. With regard to impairment among surviving low-birthweight infants, studies from newborn intensive care units show considerable variation in the reported rates of handicaps. Much of this variation arises from a lack of uniform criteria for diagnosis, sample selection and follow-up, factors further compounded by small sample size. At the present time it is premature to conclude that changes in newborn care have either lowered or raised rates of impairment among surviving low-birthweight infants.