ABSTRACT In this renewal application, we highlight the ability, commitment and strengths of Emory University to continue its more than 3 decades of participation in the Eunice Kennedy Shriver NICHD Multicenter Neonatal Research Network (NRN). As the largest metropolitan city in the US with a single perinatal-referral center (Emory) and single academic children's health system (Children's Healthcare of Atlanta-CHOA), we have a large pool of high-risk admissions. Our center brings together 3 Emory-affiliated Atlanta hospitals: Grady Memorial Hospital, the largest hospital in Georgia with a focus on caring for underserved populations; Emory University Hospital Midtown, a high-volume delivery hospital and high-risk maternal center; and CHOA at Egleston, a quaternary referral center. These sites care for ~8,000 live-births and 1,800 neonatal admissions per year with a single group of neonatologists from the Pediatric Institute at Emory and CHOA. The inborn extremely preterm infants and their families comprise populations typically under-enrolled in neonatal trials (87% Black; 3% White) with diverse sociodemographic characteristics. The Emory center has deep expertise in clinical trials and epidemiology and a robust infrastructure for clinical research with strong institutional support. Dr. Ravi Patel will continue to lead the Emory site. He has been NRN PI since 2020 and served as site-PI for 6 randomized trials since 2012. He has nationally-recognized expertise in neonatal transfusion medicine, necrotizing enterocolitis, caffeine therapy and perinatal epidemiology. Additionally, Dr. Patel received scientific approval by the NRN Steering Committee for a randomized trial of platelet transfusion strategies that could be implemented in the upcoming cycle. Dr. Brenda Poindexter, Chief of the Division of Neonatology, is an established clinical investigator and internationally renowned researcher in neonatal nutrition. She will continue as alternate PI, bringing long-standing expertise and service to the NRN as Chair of the Protocol Subcommittee and as NRN PI for two prior institutions (Indiana University, 2006-2014 and Cincinnati Children's, 2014-2020). Dr. Nathalie Maitre will continue as follow-up PI, a role she began in 2016. She is a neuroscientist and established follow-up investigator with unique expertise in the development of quantitative measures of infant neural function. Drs. Barbara Stoll and Lucky Jain will continue as collaborators, along with a cadre of other talented investigators. Emory investigators led the two most cited NRN publications in the past decade. Additional strengths include: 1) A consolidated neonatology research infrastructure directed by the PI with 4.5 FTE of coordinators. This ensures prioritization of NRN studies and the ability to enroll 24/7; 2) Comprehensive follow-up program, with one of the highest follow-up rates in the NRN and 5 trials with 100% follow-up; 3) Close academic links to the Marcus Autism center, Emory...