The integrity of the immature nervous system may be compromised by hypoxic-ischemic events, placing preterm infants at risk for brain injury. Aim: The primary objective of this historical prospective study is to determine if chronic lung disease augments the risk for specific neuromotor sequelae. Methods: Neuromotor performance at school age is being documented in 27 children with a history of severe bronchopulmonary dysplasia(Shennan's criteria) who had required prolonged home oxygen therapy, compared to 27 preterm peers (controls) matched for gestational age, birthweight and gender. To date, 21 subjects and 18 controls have been evaluated; examiners were blinded to perinatal history. Standardized outcome measures included the Bruininks-Oseretsky Test of Motor Proficiency, Beery Test of Visual-Motor Integration, Quick Neurological Screening Test, the Steadiness Tester, and neurologic examination. Mean age at assessment was 10.1 years (+/- 1.9). Mean gestational age was 29.0 weeks (+/- 2.3), mean birthweight was 1215.6 grams(+/- 382.0), and females accounted for 62.5% of the cohort. There were no significant differences between subjects and controls. Results: Group comparisons revealed significant differences in the Bruininks: gross motor (p=.0122), upper extremity coordination (p=.0473) and battery standard scores (p=.0205), and on the Beery (p=.0300), with the Quick Neurological Screening Test approaching significance (p=.0603). Mean scores were consistently lower in subjects, when compared to controls. Upper extremity steadiness was significantly inferior in subjects in both hands, in supported/unsupported positions (p=.0002-.0028). Scores below 40 (1 S.D.) on the Bruininks battery were documented in 57% subjects compared to 31% of controls. Similarly, subjects were more than twice as likely to have soft signs (29% versus 12%), poor visual-motor skills (15% versus 7%), or abnormal neurologic examinations (60% versus 17%). Conclusion: Neuromotor deficits such as motor incoordination and poor postural stability are underappreciated in children born prematurely, particularly in those with severe chronic lung disease. Better definition and identification of these impairments is essential to minimize disability at school and home, and thereby improve social and educational competency.