Recent studies have suggested preterm infants born to women with preeclampsia (PE) have a reduced risk of intraventricular hemorrhage (IVH). It is unknown whether this is an independent effect of PE or another variable such as MgSO4. In order to further investigate the relationship between PE and neonatal outcome, we reviewed all infants <1500g admitted to our NICU from 7/93-7/95. Infants who received a minimum of 1 head ultrasound were included in the analysis, n=221. Student's t-test and chi-square were used to compare infants born to mothers with PE (n=43) to those without (n=178). Multivariate analysis was then performed using the significant variables. Of the infants born to mothers with PE, 4.7% developed IVH v. 20.8% without PE(p<.01); none of the infants of mothers with PE had a grade III-IV IVH or died prior to discharge v. 12.9% and 11.8% respectively of the infants without PE (both, p<.03). Infants born to mothers with PE were also less likely to require mechanical ventilation (58% v. 82.6%, p<.01), were of a higher gestational age (30.2±3.2 wk. v. 27.7±2.8 wk., p<.01), were more likely to be delivered by cesarean section (74.4% v. 46.9%, p<.01), and required less dopamine support (7% v. 31.5%, p<.01) than the infants without maternal PE. Antenatally, they were more likely to receive MgSO4 (72% v. 41.6%, p<.01) less likely to have received steroids(25.6% v. 46.6%, p<.03), have premature rupture of membranes (7% v. 39%, p<.001) or prolonged rupture of membranes (2.3% v. 24.2%, p<.01) than the infants without PE. There was no difference in birth weight, gender, Apgar scores, ventilator days, surfactant use, NEC, PDA, PVL or maternal drug use. When correcting for confounding variables by forward stepwise discriminant analysis only gestational age remained predictive of IVH, death, and ventilator support. In our population, infants born to mothers with PE are at reduced risk for IVH, death, and need for mechanical ventilation. However, this appears to be an effect of a population of preterm infants of relatively advanced gestational age and not an intrinsic effect of maternal PE or MgSO4.