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This is the 9th annual report of the Australian and New Zealand Neonatal Network and presents information on the network's 2003 annual audit of high risk neonates. Among the babies admitted to all level III Neonatal Intensive Care Units (NICUs) throughout Australia and New Zealand there were 7,178 babies who met the criteria for the Australian and New Zealand Neonatal Network’s (ANZNN) high-risk audit in 2003. This represents 2.34% of the 307,334 total live births in Australia and New Zealand in 2003. Of the babies registered to ANZNN cohort 3,250 were born before 32 completed weeks of gestational age. The number of babies in ANZNN cohort who required assisted ventilation was 6,404, and 3,594 of them were born at more than 31 weeks gestational age. There were 197 babies who were born after 31 weeks gestational age and had birth weight less than 1500 grams who did not require assisted ventilation. Of the babies who had major surgery, 613 were born after 31 weeks gestation.