Advances in neonatal care have increased survival rates for premature or low birth weight (LBW) infants but raised concerns about long-term neurosensory and psychomotor challenges. Objective: This study aimed to investigate perinatal factors linked to visual and auditory problems in ex-preterm or LBW young adults, assessing their long-term quality of life. Methods: Participants from a randomized controlled trial comparing Kangaroo-Mother Care (KMC) to conventional care were re-enrolled 20-year after. A reference group of 50 full-term individuals without risk factors was also assessed. Results: 5.9% of participants had functional visual issues, and 8.1% experienced hearing problems. Those with hearing or visual impairments had longer hospital stays and more neonatal complications. Correlations were found between Griffiths auditory sub-scale results at 6 months and long-term auditory outcomes. Only 27.5% of those with hearing problems had access to hearing aids or cochlear implants, resulting in lower IQ scores, learning difficulties, and increased risk of depression and self-harm. Participants with visual impairments exhibited lower IQ scores, self-esteem, and HOME test acceptance. However, they did not differ from the group with normal vision in terms of quality of life, depression, or attachment scores. All participants, whether they had issues or not, rated their quality of life higher than their parents did. Conclusion: preterm or LBW infants with visual and hearing deficits are more likely to face cognitive and emotional challenges in adulthood. This study underscores the importance of a multidisciplinary approach to promptly address these vulnerabilities, reducing the risk of long-term neurodevelopmental and functional issues.Funding: The authors thank the financial support for this secondary analyses from Fulbright Colciencias and Colombia Cientifica – Alianza EFI #60185 contract #FP44842- 220-2018, funded by The World Bank through the Scientific Ecosystems, managed by the Colombian Administrative Department of Science, Technology and Innovation (COLCIENCIAS).Declaration of Interest: We ( all authors) have no declaration of competing interest.Ethical Approval: This study was conducted in agreement with the principles established in the Declaration of Helsinki and with the standards of Good Clinical Practice of the country. The ethics and research committee of the Kangaroo Foundation approved the protocol.