The purpose of this study was to evaluate the impact of extreme prematurity(<29 weeks gestation) on academic and neurodevelopmental outcomes. Our cohort (N=194) consisted of ELBW preterm infants (Mean BW 857g+162) born at one regional center between 1983-86 and enrolled in surfactant or maternal Betamethasone clinical trials. 153 infants (79%) survived, 4.5 y follow-up occurred in 149 (97%) and 123 (81%) were followed at ages 8-10 y. Control (C) infants were matched to each case based on birth date, mother's zip code, and health insurance at birth. Assessors (blinded to neonatal course) used the Woodcock-Johnson Psychoeducational Battery (WJ), Vineland Adaptive Behavior Scales (VABS, Mean 100±15), Parents and Teachers Connors Questionnaire(CQ) for attention (ADHD) and behavior. School age outcomes were classified as WJ scores less than 80 (Mean 100±15) for Reading (Read), Math and Spelling (Spell), Daily Living Score (DLS) <85 on VABS and CQ ADHD >2SD.Table

Table 1
Full size table

22.8% ELBW and 4.9% C required special education, 37.4% ELBW and 15.6% C had repeated a grade. Our experience demonstrates that children with ELBW in middle school years have a range of strengths and challenges. Inability to make some academic progress was rare. Supported by March of Dimes, ONY Inc., and Forest Laboratories.