Fetal complications of multiple gestation, especially prematurity, account for a significant utilization of neonatal intensive care, early intervention(EI), and special education services. The purpose of our study is to examine the outcome of VLBW infants in the era of newer trends in antepartum(including IVF) and neonatal care, comparing singletons to multiples. The study cohort consisted of 670 infants with a BW<1250g born in 1991-1995, admitted to Women & Infants Hospital NICU. Twenty-three% were multiples(N=158), all being twins or triplets. Of the 548 survivors at 18 mos. corrected age, 324 were assessed by history, physical, growth measurements, neurological examination, and the Bayley Scales of Infant Development. Singletons were more likely than multiples to be minority (p<.05). Mothers of the multiple gestation infants had a ↑SES (p<.001) and were more likely to be married (p<.005) and high school educated (p<.001). Multiples were more likely to have received surfactant (p<.025). There was no difference between groups in mean BW (905g), gest. age (27.1 wks.), days 02(32.4), mortality (18.2%), grade 3 or 4 IVH (12%), PVL (4.7%), or enrollment in EI (54%). Severe cerebral palsy (CP) was defined as not sitting at 18 mos., and mild-moderate CP was the inability to walk with assistance. Disability was defined as any of these: MDI<70, PDI<70, deafness or blindness. Table

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Although the multiple VLBW infants had favorable environmental influences(e.g., SES, maternal education), their mean MDI was lower, and the moderate CP rate was higher than singletons at 18 mos. However, rates of severe CP, MDI<70, and total disability were not significantly different. These findings suggest the need for further study of the multiple gestation VLBW infant. The overall disability rate (37%) indicates a substantial requirement for early intervention services.