{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T20:45:41Z","timestamp":1793652341847,"version":"4.5.1"},"reference-count":43,"publisher":"Ordem dos Medicos","issue":"5","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Med Port"],"abstract":"<jats:p>Introduction: Advances in medical care have significantly improved survival rates for preterm infants globally, leading to an increase of population of newborns at neurological risk. Knowledge of gestational age-specific outcomes is essential to guide and provide the best medical care. This study aimed to evaluate the impact of gestational age in mortality and neurodevelopment of very preterm infants. As a secondary objective, we aimed to determine the influence of perinatal factors on the combined outcome of neurodevelopmental impairment or death.Methods: We conducted a retrospective cohort study of all infants born before completing 32 weeks of gestational age, admitted to the Neonatal Intensive Care Unit in a tertiary maternity hospital in Portugal from 2013 to 2021. Neurodevelopment was assessed at 24 months of corrected age, using Griffiths Mental Developmental Scales II. Moderate to severe neurodevelopment impairment was considered in the presence of at least one of the following criteria: global development quotient &lt; 70, cerebral palsy, severe visual impairment or profound sensorineural deafness.Results: There were 311 very preterm infants assessed for eligibility, 10.9% neonatal deaths and 11.9% losses to follow-up. Neurodevelopment evaluation was performed on 274 infants, of whom 6.2% (17\/274) had moderate to severe neurodevelopment impairment: 7.5% (5\/67) born before 28 weeks of gestational age and 5.8% (12\/207) between 28 - 31 weeks. Global development quotient &lt; 70 was verified in 4.7% of cases. Cerebral palsy was diagnosed in 3.3%, severe visual impairment in 0.7% and profound sensorineural deafness in 0.7%. The survival rate without moderate to severe neurodevelopment impairment exceeded deaths at 25 weeks and was &gt; 86% from 28 weeks onward. In multivariable logistic regression analysis, gestational age was identified as a protective factor for moderate to severe neurodevelopment impairment or death (aOR 0.81; CI 95% 0.68 - 0.98), whereas male sex (aOR 3.19; CI 95% 1.57 - 6.71) and resuscitation with tracheal intubation (aOR 8.17; CI 95% 3.16 - 20.96) were independent risk factors.Conclusion: This study reaffirms gestational age as a key determinant of survival and neurodevelopmental outcomes in very preterm infants, with those born before 28 weeks facing higher risks of mortality and severe neurodevelopmental impairments. Understanding local survival rates and neurodevelopmental outcomes is paramount for guiding perinatal decision-making and providing accurate evidence-based counseling to parents of preterm infants.<\/jats:p>","DOI":"10.20344\/amp.22345","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T11:06:09Z","timestamp":1746183969000},"page":"288-296","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of Survival and Neurodevelopment in Neonates Born Very Preterm at a Tertiary Centre in Portugal"],"prefix":"10.20344","volume":"38","author":[{"given":"Margarida","family":"Camacho-Sampaio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina","family":"Cordeiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina","family":"Leuzinger-Dias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Dias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolores","family":"Faria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelaide","family":"Taborda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"8464","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"9209","doi-asserted-by":"crossref","unstructured":"Bell EF, Hintz SR, Hansen NI, Bann CM, Wyckoff MH, DeMauro SB, et al. Mortality, In-hospital morbidity, care practices, and 2-year outcomes for extremely preterm infants in the US, 2013-2018. JAMA. 2022;327:248- 63.","DOI":"10.1097\/01.aoa.0000891644.03402.e8"},{"key":"9210","doi-asserted-by":"crossref","unstructured":"Molad M, Gover A, Marai Z, Lavie-Nevo K, Kessel I, Shemer-Meiri L, et al. Neurodevelopmental outcome of very low birth weight infants in the northern district of israel: a cross-sectional study. Children. 2023;10:1320.","DOI":"10.3390\/children10081320"},{"key":"9211","doi-asserted-by":"crossref","unstructured":"Pierrat V, Marchand-Martin L, Arnaud C, Kaminski M, Resche-Rigon M, Lebeaux C, et al. Neurodevelopmental outcome at 2 years for preterm children born at 22 to 34 weeks\u2019 gestation in France in 2011: EPIPAGE-2 cohort study. BMJ. 2017;358:j3448.","DOI":"10.1136\/bmj.j3448"},{"key":"9212","doi-asserted-by":"crossref","unstructured":"Resende CM, Martins D, Faria D, Taborda A. Neurodesenvolvimento em crian\u00e7as nascidas pr\u00e9-termo de muito baixo peso: fatores de risco ambientais e biol\u00f3gicos. Acta Pediatr Port. 2017;48:212-21.","DOI":"10.21069\/app.2017.10366"},{"key":"9213","doi-asserted-by":"crossref","unstructured":"Serenius F, Ewald U, Farooqi A, Fellman V, Hafstr\u00f6m M, Hellgren K, et al. Neurodevelopmental outcomes among extremely preterm infants 6.5 years after active perinatal care in Sweden. JAMA Pediatr. 2016;170:954-63.","DOI":"10.1001\/jamapediatrics.2016.1210"},{"key":"9214","doi-asserted-by":"crossref","unstructured":"Arpino C, Compagnone E, Montanaro ML, Cacciatore D, De Luca A, Cerulli A, et al. Preterm birth and neurodevelopmental outcome: a review. Childs Nerv Syst. 2010;26:1139-49.","DOI":"10.1007\/s00381-010-1125-y"},{"key":"9215","doi-asserted-by":"crossref","unstructured":"Gebus M, Chevallier M, Hatton LA, Jacquez L, Vilotitch A, Ego A, et al. Neurodevelopment at two years and appropriate schooling at five years in children born very preterm. Acta Paediatr. 2022;111:1729-35.","DOI":"10.1111\/apa.16421"},{"key":"9216","doi-asserted-by":"crossref","unstructured":"Larroque B, Ancel PY, Marret S, Marchand L, Andr\u00e9 M, Arnaud C, et al. Neurodevelopmental disabilities and special care of 5-year-old children born before 33 weeks of gestation (the EPIPAGE study): a longitudinal cohort study. Lancet. 2008;371:813-20.","DOI":"10.1016\/S0140-6736(08)60380-3"},{"key":"9217","doi-asserted-by":"crossref","unstructured":"Charkaluk ML, Truffert P, Fily A, Ancel PY, Pierrat V. Neurodevelopment of children born very preterm and free of severe disabilities: the Nord- Pas de Calais Epipage cohort study. Acta Paediatr. 2010;99:684-9.","DOI":"10.1111\/j.1651-2227.2010.01695.x"},{"key":"9218","doi-asserted-by":"crossref","unstructured":"Brydges CR, Landes JK, Reid CL, Campbell C, French N, Anderson M. Cognitive outcomes in children and adolescents born very preterm: a meta-analysis. Dev Med Child Neurol. 2018;60:452-68.","DOI":"10.1111\/dmcn.13685"},{"key":"9219","doi-asserted-by":"crossref","unstructured":"Wickremasinghe AC, Hartman TK, Voigt RG, Katusic SK, Weaver AL, Colby CE, et al. Evaluation of the ability of neurobiological, neurodevelopmental and socio-economic variables to predict cognitive outcome in premature infants. Child Care Health Dev. 2012;38:683-9.","DOI":"10.1111\/j.1365-2214.2011.01281.x"},{"key":"9220","doi-asserted-by":"crossref","unstructured":"Voss W, Jungmann T, Wachtendorf M, Neubauer AP. Long-term cognitive outcomes of extremely low-birth-weight infants: the influence of the maternal educational background. Acta Paediatr. 2012;101:569- 73.","DOI":"10.1111\/j.1651-2227.2012.02601.x"},{"key":"9221","doi-asserted-by":"crossref","unstructured":"Schlapbach LJ, Aebischer M, Adams M, Natalucci G, Bonhoeffer J, Latzin P, et al. 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Follow-Up care for high-risk preterm infants. Pediatr Ann. 2018;47:e142-6.","DOI":"10.3928\/19382359-20180325-03"},{"key":"9243","doi-asserted-by":"crossref","unstructured":"Lugli L, Pugliese M, Bertoncelli N, Bedetti L, Agnini C, Guidotti I, et al. Neurodevelopmental outcome and neuroimaging of very low birth weight infants from an Italian NICU adopting the family-centered care model. Children. 2023;11:12.","DOI":"10.3390\/children11010012"},{"key":"9244","doi-asserted-by":"crossref","unstructured":"Kiechl-Kohlendorfer U, Ralser E, Pupp Peglow U, Reiter G, Traw\u00f6ger R. Adverse neurodevelopmental outcome in preterm infants: risk factor profiles for different gestational ages. Acta Paediatr. 2009;98:792-6.","DOI":"10.1111\/j.1651-2227.2009.01219.x"},{"key":"9245","doi-asserted-by":"crossref","unstructured":"Synnes A, Luu TM, Moddemann D, Church P, Lee D, Vincer M, et al. Determinants of developmental outcomes in a very preterm Canadian cohort. 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