Twilhaar ES, et al. - The cognitive abilities of children of extremely or very preterm (EP/VP) births [EP/VP children] and the role of perinatal and demographic risk factors were comprehensively studied. Large deficits in intelligence were illustrated among extremely or very preterm children born in the antenatal corticosteroids and surfactant era. Findings did not report any improvement in cognitive outcomes between 1990 and 2008. It was determined that improving outcomes after EP/VP birth is a major challenge. Bronchopulmonary dysplasia (BPD) appeared to be a pivotal factor for cognitive outcome. Lowering the high incidence of BPD could serve as a key for improving the long-term outcomes after EP/VP birth.