Objective-To examine the self-perceived health of very low birth weight (VLBW; <1.5 kg) infants during young adulthood.Study design-The population included 241 VLBW and 232 normal birth weight (NBW) controls who completed the Child Health and Illness Profile: Adolescent Edition (CHIP-AE) at 20 years of age. The CHIP-AE includes six domains: Satisfaction, Comfort, Resilience, Achievement, Risk Avoidance, and Disorders, and 13 profiles that characterize patterns of health. Results were compared between VLBW and NBW subjects adjusting for sex and sociodemographic status.Results-VLBW subjects did not differ from NBW controls in the domains of Satisfaction or Comfort but reported less Resilience (effect size [ES] −0.19, P < .05), specifically in physical activity and family involvement. They reported better Achievement, specifically in work performance (ES 0.28, P < .05), more Risk Avoidance (ES 0.43, P < .001), and significantly more long-term medical, surgical, and psychosocial disorders. Similar proportions of VLBW and NBW subjects reported Excellent (15% vs 11%), Average (27% vs 34%), and Poor (12% vs 13%) profiles of health.Conclusions-VLBW subjects report similar health, well-being, and functioning compared with NBW controls and greater risk avoidance. However, we are concerned that their lesser resilience may prove detrimental to their future adult health.Reports of the young adult outcomes of very low birth weight children (VLBW; <1.5 kg) who were the initial survivors of neonatal intensive care have included educational achievement and various aspects of health and behavior. 1-4 The reports of health outcomes have, with few exceptions, 2,3 pertained to specific biological markers of health such as neurosensory impairments and other chronic conditions. 1,3,5-7 There has been very little prior research on the overall impact of VLBW on young adults' self-perceived health, functioning, and wellbeing. 2,3 This broader concept of self-assessed health has been termed "health-related quality of life," which is widely considered to be an important outcome of medical interventions, because it constitutes the individual's own experiences and evaluations of health.As part of a longitudinal study of the outcomes of a cohort of VLBW young adults born during the years 1977 through 1979, we previously reported on outcomes at 20 years of age, including To more fully describe the health experiences of VLBW children as compared with normal birth weight (NBW) controls at 20 years of age, we used the Child Health and Illness Profile: Adolescent Edition (CHIP-AE) a multidimensional self-report instrument that is based on a framework of health-related quality of life that includes satisfaction with health and self, comfort feelings, psychosocial resiliencies, risk behaviors, and achievement in academic and work settings. The CHIP-AE also includes biological markers of medical health and psychosocial disorders. 10,11 We hypothesized that the self-perceived health-related quality of life of our population would be determined...