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Updated: Jul 5, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurologic and developmental disability after extremely preterm birth. EPICure Study Group
N S Wood1, N Marlow, K Costeloe
1School of Human Development, University of Nottingham, United Kingdom.
Insights
Severe disability is common in extremely preterm infants. Nearly half of infants born at 25 weeks or less experienced disability by 30 months corrected age, with many facing severe developmental challenges.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Public Health
Background:
- Extremely preterm infants often experience neurologic and developmental disabilities.
- Previous small studies indicated a high prevalence of these issues.
Purpose of the Study:
- To evaluate the neurologic and developmental outcomes of extremely preterm infants.
- To determine the prevalence of disability in this vulnerable population.
Main Methods:
- A cohort of infants born at 25 or fewer completed weeks of gestation in the UK and Ireland were assessed at a median corrected age of 30 months.
- Assessments included the Bayley Scales of Infant Development and standardized neurologic examinations.
- Disability and severe disability were defined by predetermined criteria.
Main Results:
- Of 308 surviving infants, 283 (92%) were assessed. Mean Bayley scores were 84 (Mental) and 87 (Psychomotor).
- 19% had severely delayed development, and 10% had severe neuromotor disability.
- Overall, 49% had disability, with 23% meeting criteria for severe disability.
Conclusions:
- Severe disability is a common outcome for extremely preterm infants.
- These findings highlight the significant long-term challenges faced by this population.
Background And Methods:
Small studies show that many children born as extremely preterm infants have neurologic and developmental disabilities. We evaluated all children who were born at 25 or fewer completed weeks of gestation in the United Kingdom and Ireland from March through December 1995 at the time when they reached a median age of 30 months. Each child underwent a formal assessment by an independent examiner. Development was evaluated with use of the Bayley Scales of Infant Development, and neurologic function was assessed by a standardized examination. Disability and severe disability were defined by predetermined criteria.
Results:
At a median age of 30 months, corrected for gestational age, 283 (92 percent) of the 308 surviving children were formally assessed. The mean (+/-SD) scores on the Bayley Mental and Psychomotor Developmental Indexes, referenced to a population mean of 100, were 84+/-12 and 87+/-13, respectively. Fifty-three children (19 percent) had severely delayed development (with scores more than 3 SD below the mean), and a further 32 children (11 percent) had scores from 2 SD to 3 SD below the mean. Twenty-eight children (10 percent) had severe neuromotor disability, 7 (2 percent) were blind or perceived light only, and 8 (3 percent) had hearing loss that was uncorrectable or required aids. Overall, 138 children had disability (49 percent; 95 percent confidence interval, 43 to 55 percent), including 64 who met the criteria for severe disability (23 percent; 95 percent confidence interval, 18 to 28 percent). When data from 17 assessments by local pediatricians were included, 155 of the 314 infants discharged (49 percent) had no disability.
Conclusions:
Severe disability is common among children born as extremely preterm infants.
