Preterm birth carries a risk for impaired developmental outcome. We have previously described an association between increased levels of proinflammatory cytokines during the first 72 postnatal hours and cerebral damage as detected by ultrasound in a cohort of 74 very preterm infants. Sixty-seven of 71 surviving children with a mean gestational age of 27.1 (2.0) wk were examined at 2 y corrected age with a standardized neurologic examination and with Bayley Scales of Infant Development. We hypothesized that proinflammatory cytokine concentrations at or shortly after birth would be associated with an adverse developmental outcome. Increased concentrations of TNF-␣ in cord blood odds ratio (95% confidence interval) 3.3 (1.1-10.2), p ϭ 0.013 and at 6 h 7.8 (0.9 -71.8), p ϭ 0.015 and of IL-6 in cord blood 1.7 (1.0 -2.9), p ϭ 0.048 were associated with psychomotor developmental index Ͻ85. Increased concentrations of TNF-␣ in cord blood odds ratio (95% confidence interval) 3.6 (1.002-12.8), p ϭ 0.044 and of IL-8 in cord blood 3.5 (1.2-10.6), p ϭ 0.023 were associated with cerebral palsy. Associations of TNF-␣ and IL-8 in cord blood with the respective outcome measures remained significant after adjustment for other clinical variables. Proinflammation at birth is associated with impaired functional outcome at 2 y of corrected age in children with very preterm birth. (Pediatr Res 64: 183-188, 2008)

Fifty-two extremely premature born and 54 full-term controls were assessed regarding behavioral outcomes, risk-taking and self-perceived quality of life. Behavioral outcomes were assessed with the Achenbach Youth Self Report; risk-taking was estimated regarding alcohol and nicotine use; self-perceived quality of life and future expectations were rated; and attention and hyperactivity problems were surveyed retrospectively with the Wender Utah Rating Scale. The prematurely born reported fewer problems than full-term born on the externalizing scale (delinquent behavior and aggressive behaviour); and they reported less alcohol consumption. No difference was observed between the two groups concerning nicotine use, views about quality of life and expectations for the future or in the retrospective assessment of attention and hyper-activity problems. Conclusively, the prematurely born adolescents described a quality of life and future expectations comparable to full-term born controls. They also reported fewer behavioral problems and less risk-taking behavior.

Poorer cognitive performance, in extremely preterm born individuals, seems to persist into late adolescence. Fewer prematurely born than control chose theoretical upper secondary school programmes. However, no difference was noted regarding self-perceived health aspects.

Extremely preterm born adolescents did not experience more problems regarding mental health compared to controls. Nevertheless, they reported less social interaction and, to a greater extent, a negative model of self.

Because insecure attachment as well as prematurity may be considered as significant risk factors for developing psychopathology, they deserve careful attention in future research and clinical follow-ups.