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Extremely preterm (EP) infants have high rates of respiratory morbidity and correspondingly high healthcare resource utilization. Data from the PHARMO Perinatal Research Network were analyzed to quantify the burden of EP birth in the Netherlands. A retrospective analysis included infants 28 weeks gestational age with a birth record in the Perinatal Registry (1999-2015) and data in the PHARMO Database Network. Outcomes of interest included select comorbidities, hospital readmissions, and costs of hospitalization and me