The purpose of this study was to assess predictors of developmental outcome at two years in VLBW infants. Five centers that participated in a multicenter randomized double-masked comparison trial of two surfactants (Exosurf and Infasurf) for the prophylaxis and treatment of respiratory distress syndrome were prospectively invited to participate in a four-year neurodevelopmental follow-up study. 299 infants received both Year 1 (Y1) and Year 2 (Y2) assessments using the Bayley scales, and neurodevelopmental examination performed by assessors masked to treatment. Outcomes were classified as Group 1: Bayley MDI and PDI >89. Group 2: MDI and/or PDI 70-89. Group 3: MDI or PDI 50-69. Group 4: MDI or PDI <50. Growth outcomes at one year were compared using WHO international reference curves and standardized as multiple of standard deviations from the mean (z score). 48% of infants did not change; 7% improved and 45% declined in developmental status between Y1 and Y2 (n = 287). Of 91 suspect children, 54% did not change, 12% improved and 34% declined. Conclusion: Children with CPVL, low maternal education, and microcephally at age Y1 were most likely to have severe neurodevelopmental disorders at age 2 years. Table

Table 1
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