@article {SynnesF235, author = {Anne Synnes and Thuy Mai Luu and Diane Moddemann and Paige Church and David Lee and Michael Vincer and Marilyn Ballantyne and Annette Majnemer and Dianne Creighton and Junmin Yang and Reginald Sauve and Saroj Saigal and Prakesh Shah and Shoo K Lee}, editor = {, and Harrison, Adele and Ting, Joseph and Yee, Wendy and Aziz, Khalid and Toye, Jennifer and Kalapesi, Zarin and Sankaran, Koravangattu and Daspal, Sibasis and Seshia, Mary and Alvaro, Ruben and Shivananda, Sandesh and Da Silva, Orlando and Nwaesei, Chukwuma and Lee, Kyong-Soon and Dunn, Michael and Rouvinez-Bouali, Nicole and Dow, Kimberly and Pelausa, Ermelinda and Kovacs, Lajos and Barrington, Keith and Drolet, Christine and Piedboeuf, Bruno and Riley, S Patricia and Claveau, Martine and Faucher, Daniel and Bertelle, Valerie and Masse, Edith and Canning, Roderick and Makary, Hala and Ojah, Cecil and Monterrosa, Luis and Andrews, Wayne and Deshpandey, Akhil and McMillan, Doug and Afifi, Jehier and Pillay, Thevanisha and Synnes, Anne and Sauv{\'e}, Reg and Reichert, Amber and Bodani, Jaya and Sankaran, Koravangattu and Nwaesei, Chukwuma and Daboval, Thierry and Dow, Kimberly and Ly, Linh and Kelly, Edmond and Helou, Salhab el and Pelausa, Ermelinda and Riley, S Patricia and Levebvre, Francine and Demers, Charlotte and B{\'e}langer, Sylvie and Canning, Roderick and Monterrosa, Luis and Makary, Hala and Murphy, Phil}, title = {Determinants of developmental outcomes in a very preterm Canadian cohort}, volume = {102}, number = {3}, pages = {F235--F234}, year = {2017}, doi = {10.1136/archdischild-2016-311228}, publisher = {BMJ Publishing Group}, abstract = {Objectives Identify determinants of neurodevelopmental outcome in preterm children.Methods Prospective national cohort study of children born between 2009 and 2011 at \<29 weeks gestational age, admitted to one of 28 Canadian neonatal intensive care units and assessed at a Canadian Neonatal Follow-up Network site at 21 months corrected age for cerebral palsy (CP), visual, hearing and developmental status using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). Stepwise regression analyses evaluated the effect of (1) prenatal and neonatal characteristics, (2) admission severity of illness, (3) major neonatal morbidities, (4) neonatal neuroimaging abnormalities, and (5) site on neurodevelopmental impairment (NDI) (Bayley-III score \< 85, any CP, visual or hearing impairment), significant neurodevelopmental impairment (sNDI) (Bayley-III \< 70, severe CP, blind or hearing aided and sNDI or death.Results Of the 3700 admissions without severe congenital anomalies, 84\% survived to discharge and of the 2340 admissions, 46\% (IQR site variation 38\%{\textendash}51\%) had a NDI, 17\% (11\%{\textendash}23\%) had a sNDI, 6.4\% (3.1\%{\textendash}8.6\%) had CP, 2.6\% (2.5\%{\textendash}13.3\%) had hearing aids or cochlear implants and 1.6\% (0\%{\textendash}3.1\%) had a bilateral visual impairment. Bayley-III composite scores of \<70 for cognitive, language and motor domains were 3.3\%, 10.9\% and 6.7\%, respectively. Gestational age, sex, outborn, illness severity, bronchopulmonary dysplasia, necrotising enterocolitis, late-onset sepsis, retinopathy of prematurity, abnormal neuroimaging and site were significantly associated with NDI or sNDI. Site variation ORs for NDI, sNDI and sNDI/death ranged from 0.3{\textendash}4.3, 0.04{\textendash}3.5 and 0.12{\textendash}1.96, respectively.Conclusion Most preterm survivors are free of sNDI. The risk factors, including site, associated with neurodevelopmental status suggest opportunities for improving outcomes.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/102/3/F235}, eprint = {https://fn.bmj.com/content/102/3/F235.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }