JOURNAL OF PERINATOLOGY, 2025 (SCI-Expanded)
                        
                            
                        
                        
                            
                        
                        
            
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 1589 eligible infants, 1017 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.