{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:00:11Z","timestamp":1790265611912,"version":"4.1.0"},"reference-count":31,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000031","name":"Institute of Human Development, Child and Youth Health","doi-asserted-by":"publisher","award":["CTP 87518"],"award-info":[{"award-number":["CTP 87518"]}],"id":[{"id":"10.13039\/501100000031","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2016,9,8]]},"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Identify determinants of neurodevelopmental outcome in preterm children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective national cohort study of children born between 2009 and 2011 at &lt;29\u2005weeks gestational age, admitted to one of 28 Canadian neonatal intensive care units and assessed at a Canadian Neonatal Follow-up Network site at 21\u2005months 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 &lt; 85, any CP, visual or hearing impairment), significant neurodevelopmental impairment (sNDI) (Bayley-III &lt; 70, severe CP, blind or hearing aided and sNDI or death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 3700 admissions without severe congenital anomalies, 84% survived to discharge and of the 2340 admissions, 46% (IQR site variation 38%\u201351%) had a NDI, 17% (11%\u201323%) had a sNDI, 6.4% (3.1%\u20138.6%) had CP, 2.6% (2.5%\u201313.3%) had hearing aids or cochlear implants and 1.6% (0%\u20133.1%) had a bilateral visual impairment. Bayley-III composite scores of &lt;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\u20134.3, 0.04\u20133.5 and 0.12\u20131.96, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most preterm survivors are free of sNDI. The risk factors, including site, associated with neurodevelopmental status suggest opportunities for improving outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/archdischild-2016-311228","type":"journal-article","created":{"date-parts":[[2016,10,6]],"date-time":"2016-10-06T22:39:08Z","timestamp":1475793548000},"page":"F235-F234","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":230,"title":["Determinants of developmental outcomes in a very preterm Canadian cohort"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6917-0978","authenticated-orcid":false,"given":"Anne","family":"Synnes","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy Mai","family":"Luu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Moddemann","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Church","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Western Ontario, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Vincer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilyn","family":"Ballantyne","sequence":"additional","affiliation":[{"name":"Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Majnemer","sequence":"additional","affiliation":[{"name":"McGill University Health Centre, Montr\u00e9al, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianne","family":"Creighton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junmin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reginald","family":"Sauve","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saroj","family":"Saigal","sequence":"additional","affiliation":[{"name":"McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakesh","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoo K","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,10,6]]},"reference":[{"key":"2025090512504155000_102.3.F235.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.06.016"},{"key":"2025090512504155000_102.3.F235.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2013.09.003"},{"key":"2025090512504155000_102.3.F235.3","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.4.781"},{"key":"2025090512504155000_102.3.F235.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1410689"},{"key":"2025090512504155000_102.3.F235.5","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.081727"},{"key":"2025090512504155000_102.3.F235.6","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/pch\/20.1.e1","article-title":"The Evidence-based Practice for Improving Quality method has greater impact on improvement of outcomes than dissemination of practice change guidelines and quality improvement training in neonatal intensive care units","volume":"20","author":"Lee","year":"2015","journal-title":"Paediatr Child Health"},{"key":"2025090512504155000_102.3.F235.7","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.140399"},{"key":"2025090512504155000_102.3.F235.8","unstructured":"Canadian Neonatal Network\u2122 Funded Projects. 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