The introduction of methods of neonatal intensive care in the 1960s and 1970s led to significant improvements in the survival and neurodevelopmental outcomes of preterm infants. By the late 1970s, 65% of infants born with very low birth weight (VLBW, <1500 g) and 40% of those of extremely low birth weight (ELBW, <1000 g) survived,1 of whom 70% to 90% were reported to be without serious impairment during early childhood.1 However, additional problems became evident during the school age and adolescent years. When compared with term-born children, preterm children demonstrated poorer cognitive function and academic performance; more behavioral problems, mainly hyperactivity and attentional weaknesses but also shy and withdrawn behavior; problems with social skills; and anxiety and depression.2 Chronic health problems were also more prevalent and included those problems associated with cerebral palsy, asthma, and visual and hearing impairments. These developmental, behavioral, and health problems led to concern as to how the children would function as they approached adulthood.
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