In this issue of JAMA, Stoll and colleagues report on care practices, morbidity, and mortality of 34 636 infants 22 through 28 weeks’ gestation, weighing 401 to 1500 g, born at 26 National Institute of Child Health and Human Development (NICHD) Neonatal Research Network centers between 1993 and 2012.1 This article provides an important historical perspective over the last 2 decades in neonatal-perinatal medicine and the most recent update on trends in neonatal care.