Aim:To determine the type and rate of disability at 2 years of age in infants born in the geographically defined population of East Anglia with a birthweight less than 1500 g and to assess the risk factors for disability.Study design:A prospective cohort analysis from all eight neonatal units in East Anglia from 1 993—1997 using a single database.Methods:Local paediatricians assessed childr en at 2 years using the Health Status Questionnaire and data collection was cent rally coordinated.Results:Outcomes for 947 children,99%of survivors,were av ailable,74(7.8%)had severe disability and this was significantly associated with gestational age(p < 0.0005),birthweight(p < 0.0005)and sex(p = 0.046).Major congenital abnormality contributed 27%of all severe disability.The over all cerebral palsy rate was 6.2%,nine children were blind and five had sensori neural hearing loss requiring aids.These children had a high level of use of co mmunity services with 19%of the cohort being referred to one or more community service.ELBW infants or those born < 30 weeks gestation were 1.5 times and twic e as likely to have moderate or severe disability and 2.3 and 5.4 times as likel y to have cerebral palsy as those weighing 1000 to 1500 g or > 30 weeks gestatio n.Boys were at higher risk of adverse outcome.Conclusions:The study was able to define the increased risk associated with being born at lower gestational age or lower birthweight and demonstrates successful ascertainment of outcomes for large local populations at a reasonable cost. Aim: To determine the type and rate of disability at 2 years of age in infants born in the geographically defined population of East Anglia with a birthweight less than 1500 g and assess the risk factors for disability. Study design: A prospective cohort analysis from all eight neonatal units in East Anglia from 1 993-1997 using a single database. Methods: Local pediatricians assessed child r en at 2 years using the Health Status Questionnaire and data collection were taken at centrally coordinated. Results: Outcomes for 947 children, 99% of survivors, were avilable, 74 (7.8%) had severe disability and this was significantly associated with gestational age (p <0.0005), birthweight (p <0.0005) severe disability. The over all cerebral palsy rate was 6.2%, nine children were blind and five had sensori neural hearing loss requiring aids. These children had a high level of use of co mmunity services with 19% of the cohort being referred to on e or more community service. ELBW infants or those born <30 weeks gestation were 1.5 times and twic e as likely to have moderate or severe disability and 2.3 and 5.4 times as likel y to have cerebral palsy as those weighing 1000 to 1500 g or> 30 weeks gestatio n.Boys were at higher risk of adverse outcome. Conclusions: The study was able to define the increased risk associated with being born at lower gestational age or lower birthweight and injunction successful ascertainment of outcomes for large local populations at a reasonable cost .