A prospective cohort study compared infants assigned to be managed within single rooms versus an open ward within the same hospital. Infants were assigned based on availability of staff and space and remained in their assigned space from admission until discharge. At follow-up, infants in private rooms had more findings of concern. At term equivalent age, they had a diminution of normal hemispheric asymmetry and a trend toward lower cerebral maturation scores on amplitude integrated electroencephalography. At age 2 years, they had lower language scores and a trend toward lower motor scores, which persisted after adjustment for potential confounders.