Although there were no significant differences in mortality between OP and controls, OP mortality was high at 25.0% compared to 8.3%. However, the deaths among the OP cohort were not directly related to OP itself. Patients with OP had higher risk of having moderate to severe intraventricular haemorrhage (IVH grades 2-3 by Volpe classification) OR 5.00 (p<0.05) and combined moderate-severe IVH with mortality, OR 5.86, p<0.01. Conclusions OP is a rare complication among smaller VLBW infants. There was a high incidence of mortality of 25.0%, air leak syndrome and moderate to severe IVH.