Abstract
OBJECTIVES: To investigate neurodevelopmental outcomes and associated risk factors in extremely preterm infants (EPIs) at 2-3 years of corrected age. METHODS: A retrospective study included EPIs (EPI group, n=122) at 2-3 years of corrected age who were followed at the High-Risk Infant Clinic of Shenzhen Maternity and Child Healthcare Hospital and normal full-term infants aged 2-3 years (term group; n=154) during the same period from January 2018 to December 2024. Neurodevelopmental outcomes were compared between groups, and risk factors for neurodevelopmental impairment (NDI) in EPIs were analyzed. RESULTS: The EPI group had a lower general developmental quotient and lower developmental quotients in gross motor, hand-eye coordination, and visual performance than the term group (P<0.05). In the EPI group, the proportions of no NDI, mild NDI, and moderate-to-severe NDI were 50.8% (62/122), 36.1% (44/122), and 13.1% (16/122), respectively; the proportions with cerebral palsy and global developmental delay were 2.5% (3/122) and 7.4% (9/122), respectively. The proportions of moderate-to-severe NDI and global developmental delay were higher in the EPI group than in the term group (P<0.05). The incidence of moderate-to-severe NDI did not differ between EPIs born at 22-24(+6) weeks and those born at 25-27(+6) weeks (P>0.05). Periventricular leukomalacia was a risk factor for moderate-to-severe NDI (OR=13.511, 95%CI: 1.370-133.235) in EPIs, whereas a higher 1-minute Apgar score was protective (OR=0.589, 95%CI: 0.437-0.795). CONCLUSIONS: At 2-3 years of corrected age, EPIs have a lower general developmental quotient than term infants, with significant deficits in gross motor, hand-eye coordination, and visual performance. The proportion with NDI is relatively high; periventricular leukomalacia is an important risk factor, and a higher 1-minute Apgar score may confer neurodevelopmental benefits.