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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Neurodevelopmental profile in low-risk preterm infants at 5 years of age

J W Pasman1, J J Rotteveel, B Maassen

  • 1Department of Clinical Neurophysiology, University Hospital Nijmegen, The Netherlands.

European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society
|March 22, 2000
PubMed

Insights

Most low-risk preterm infants develop typically. However, a few experience moderate to severe neurodevelopmental impairments, impacting visual-motor skills, concentration, and memory.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Child Psychology

Background:

  • Preterm birth (born before 37 weeks gestation) is a significant risk factor for neurodevelopmental challenges.
  • Low-risk preterm infants, defined by favorable neonatal risk scores, are generally expected to have positive outcomes.
  • However, the precise neurodevelopmental trajectory and the distribution of impairments in this group require further clarification.

Purpose of the Study:

  • To characterize the neurodevelopmental profile of low-risk preterm infants at 5 years of age.
  • To ascertain whether observed unfavorable outcomes stem from widespread mild impairments or concentrated moderate-to-severe impairments in a subset of infants.
  • To compare the neurodevelopmental outcomes of low-risk preterm infants with those of healthy, full-term infants.

Main Methods:

  • A prospective study involving 44 low-risk preterm infants (25-34 weeks gestational age) and 18 healthy term-born controls.
  • Neurological examinations and comprehensive neuropsychological testing were conducted at 5 years of age.
  • Statistical analysis was employed to compare outcomes between the preterm and term groups and to identify patterns of impairment within the preterm cohort.

Main Results:

  • Low-risk preterm infants, as a group, exhibited a less favorable neurodevelopmental outcome compared to term infants.
  • This overall poorer outcome was primarily driven by significant impairments in 12 out of 44 preterm infants.
  • The majority of low-risk preterm infants demonstrated neurodevelopmental scores comparable to their term-born peers.
  • Impairments in affected preterm infants were notably observed in visual-motor integration, concentration, and auditory memory, alongside integrative functions.

Conclusions:

  • The unfavorable neurodevelopmental outcome in the low-risk preterm group is attributable to moderate-to-severe impairments in a small subgroup, not mild deficits across the majority.
  • This finding underscores the importance of targeted neurodevelopmental surveillance for preterm infants, even those considered low-risk.
  • Specific areas of deficit in affected preterm infants highlight potential targets for early intervention and support.

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