Association of NICU Design on Neurodevelopmental Outcomes in Preterm Neonates Born at Less Than 29 Weeks’ Gestation: A Retrospective Observational Study

Objectives To compare neurodevelopmental outcomes at 18–30 months corrected age (CA) in infants born < 29 weeks’ gestation cared for in single-family room (SFR) versus open-bay NICUs. Methods In this retrospective cohort study, infants born < 29 weeks’ gestation were admitted to a tertiary NICU that transitioned from an open-bay to an SFR design. Two eras were compared: open-bay (2010–2014) and SFR (2015–2019). The primary outcome was significant neurodevelopmental impairment (sNDI) at 18–30 months CA. Multivariable regression adjusted for potential confounders. Results Of 1,589 eligible infants, 1,017 completed follow-up (471 open-bay, 546 SFR). Infants in SFRs had lower odds of sNDI (unadjusted OR 0.67; 95% CI, 0.48–0.94; adjusted OR 0.51; 95% CI, 0.34–0.76). The open-bay group also had higher rates of hearing loss requiring amplification, retinopathy of prematurity, and mortality before discharge. Conclusions Care in SFR NICUs was associated with improved neurodevelopmental outcomes and fewer complications compared with open-bay care.