The clinical and metabolic adaptation to extrauterine life in preterm was comprehensively evaluated in newborns with 28-34 weeks of gestation. A high incidence of aggravating factors that underlie the development of chronic fetal hypoxia has been revealed. The early neonatal events comprised impairment of cerebral flow, jaundice, oedema, respiratory disorders, infectious toxicosis, the manifestation rate being inversely proportional to the gestational age. A significant immunological impairment was noted along with the serum electrolyte imbalance and changes in bilirubin metabolism. Development and introduction of highly information assessment methods for intrauterine fetal development into practice is essential for the management of very low-birthweight infants. Dynamic follow-up of women at risk of unfavourable pregnancy outcome together with monitoring of the intrauterine fetal development, neonatal adaptation to the extrauterine life, and infants' further development would raise significantly the efficacy of the medical care of mothers and their preterm babies.