目的 了解超早产儿（extremely preterm infants, EPIs）校正2~3岁时的神经发育结局及相关危险因素，为改善其远期神经发育结局奠定基础。 方法 回顾性纳入2018年1月—2024年12月于深圳市妇幼保健院高危儿门诊随访的校正年龄2~3岁的EPIs（设为EPIs组，122例）和同期2~3岁的正常足月儿（设为足月儿组，154例）作为研究对象，比较两组神经发育结局差异，分析EPIs发生神经发育损害（neurodevelopmental impairment, NDI）的危险因素。 结果 EPIs组的校正总发育商，以及粗大运动、手眼协调和视觉表现的校正发育商低于足月儿组（P<0.05）。EPIs组无NDI、轻度NDI和中重度NDI的比例分别为50.8%（62例）、36.1%（44例）和13.1%（16例），脑性瘫痪和全面发育迟缓的比例分别为2.5%（3例）和7.4%（9例），中重度NDI和全面发育迟缓的比例高于足月儿组（P<0.05）。胎龄22~24⁺⁶周与25~27⁺⁶周EPIs的中重度NDI发生率比较差异无统计学意义（P>0.05）。脑白质软化是EPIs发生中重度NDI的危险因素（OR=13.511，95%CI：1.370~133.235），1 min Apgar评分高是中重度NDI的保护因素（OR=0.589，95%CI：0.437~0.795）。 结论 EPIs校正2~3岁时的校正总发育商低于同时期足月儿，以粗大运动、手眼协调及视觉表现差异显著。EPIs出现NDI比例较高，脑白质软化是重要危险因素。较高的1 min Apgar评分可能让EPIs校正2~3岁时神经发育获益。

Objective To investigate neurodevelopmental outcomes and associated risk factors in extremely preterm infants (EPIs) at 2-3 years of corrected age. Methods A retrospective study included EPIs (EPI group, n=122) at 2-3 years of corrected age who were followed at the High-Risk Infant Clinic of Shenzhen Maternity and Child Healthcare Hospital and normal full-term infants aged 2-3 years (term group; n=154) during the same period from January 2018 to December 2024. Neurodevelopmental outcomes were compared between groups, and risk factors for neurodevelopmental impairment (NDI) in EPIs were analyzed. Results The EPI group had a lower general developmental quotient and lower developmental quotients in gross motor, hand-eye coordination, and visual performance than the term group (P<0.05). In the EPI group, the proportions of no NDI, mild NDI, and moderate-to-severe NDI were 50.8% (62/122), 36.1% (44/122), and 13.1% (16/122), respectively; the proportions with cerebral palsy and global developmental delay were 2.5% (3/122) and 7.4% (9/122), respectively. The proportions of moderate-to-severe NDI and global developmental delay were higher in the EPI group than in the term group (P<0.05). The incidence of moderate-to-severe NDI did not differ between EPIs born at 22-24⁺⁶ weeks and those born at 25-27⁺⁶ weeks (P>0.05). Periventricular leukomalacia was a risk factor for moderate-to-severe NDI (OR=13.511, 95%CI: 1.370-133.235) in EPIs, whereas a higher 1-minute Apgar score was protective (OR=0.589, 95%CI: 0.437-0.795). Conclusions At 2-3 years of corrected age, EPIs have a lower general developmental quotient than term infants, with significant deficits in gross motor, hand-eye coordination, and visual performance. The proportion with NDI is relatively high; periventricular leukomalacia is an important risk factor, and a higher 1-minute Apgar score may confer neurodevelopmental benefits.