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This article presents a study on changes in the prevalence of cerebral palsy (CP) for children born very prematurely within a population-based program over 30 years. The objective of the study was to assess the changes in population-based, gestational age-specific prevalence rates of CP among the extremely premature. The study found that population-based CP prevalence rates for children whose gestational age was 20 to 27 weeks and who weighed 500 to 1249 grams show a steady decrease during the previous 10 years with stable or reducing mortality. This is a reversal of trends seen prior to 1992-1994.