Abstract Background As the increasing survival of preterm infants bearing lower gestational age (GA) and birth weight (BW), new challenges have emerged regarding their management and prognosis. In low- and middle-income countries, there is notable absence of prospective multicenter cohorts to accurately reflect their real treatment capacity for these preterm infants. This cohort study aims to fill this gap by investigating the impact of perinatal management on the prognosis of preterm infants in Northern China. Methods The Chinese Adverse Prognosis of Very Preterm infants (CARE-Preterm) cohort study is a prospective, multicenter, longitudinal, and open cohort study based on the Sino-northern Neonatal Network (SNN) since 2018, covering 60 neonatal intensive care units from 8 densely-populated provinces and autonomous regions in Northern China. All very preterm infants (VPIs) born with GA