In Germany and Switzerland only 20% of the high risk neonates are born in perinatal centers with a neonatal intensive care unit adjacent to the delivery rooms. Several studies have shown that both mortality and long term morbidity (i.e. brain damage, retinopathy and chronic lung disease) of very low birth weight (VLBW) infants (less than 1500 g) are by approximately 50% lower in inborns compared with outborns. The results of the Bavarian Neonatal Study and of the perinatal centers in Baden-Württemberg indicate that every year approximately 2000 VLBW infants die and 4000 survive with severe handicaps in the western states of the Federal Republic of Germany because they are not born in a perinatal center.