Some might argue that intensive care for the smallest of EPTIs raises the level of societal economic burden in an unjustified manner. But the cost of such care should be examined in relationship to how much and the manner in which society spends on other aspects of health care and the proportion of this that is generated by the population in question. Neonatal intensive care cost per life year gained is likely to be considerably less than that for many adults given intensive care.(30) When the figures for resource use by NICUs on caring for the EPTI are examined in isolation, they appear daunting. For example, in a study of 17 Canadian NICUs(34) it was found that although EPTIs comprised only 4% of admissions, they accounted for 22% of deaths, 31% of severe intraventricular hemorrhage, 22% of chronic lung disease, 59% of severe retinopathy of prematurity, and 20% of necrotizing enterocolitis. They consumed 11% of NICU days, 20% of mechanical ventilator use, 35% of transfusions, 21% of surgically inserted central venous catheters, and 8% of major surgical procedures. Lorenz et al.(22) reported on the resource expenditure in the perinatal period generated by EPTIs born less than 26 weeks in two population-based cohorts, New Jersey (NJ) and the Netherlands, who received systematically different approaches to their care during the midmed-1980s. In the NJ cohort, almost all the babies received intensive care, whereas the policy was more selective in the Netherlands.