In a Dutch national collaborative study on 1338 infants, born in 1983 after a pregnancy of less than 32 weeks and/or with a birth weight of less than 1500 g, a comparison was made between maternal transport to university hospital perinatal centers and delivery in local or regional general hospitals and between neonatal transport to university hospital neonatal centers and treatment in local or regional general hospitals. The risk of mortality was investigated by means of logistic regression analysis including 27 perinatal risk factors as confounding variables. The results showed that infants born after maternal transport to centers had a significantly lower mortality risk. Infants treated in centers after neonatal transport had a lower mortality risk as well, but this was not statistically significant at a .05 level. The results of the study confirm that referral by maternal transport to level III centers offers the best prospects for high-risk preterm infants.