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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Longitudinal neurologic follow-up in neonatal intensive care unit survivors with various neonatal morbidities
M M McGrath1, M C Sullivan, B M Lester
1University of Rhode Island, College of Nursing, Kingston, Rhode Island, USA.
Insights
Neonatal complications significantly impact preterm infants' neurologic development and school performance. Early detection of neurologic issues is crucial for better cognitive and academic outcomes in low birth weight children.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Neuroscience
Background:
- Low birth weight infants face risks for neurodevelopmental challenges.
- Neonatal morbidity can influence long-term cognitive and academic trajectories.
- Understanding these links is vital for early intervention strategies.
Purpose of the Study:
- To investigate neurocognitive and school performance in low birth weight infants.
- To correlate outcomes with neonatal morbidity and socioeconomic status.
- To assess cognition and school performance based on neurologic status over 8 years.
Main Methods:
- A longitudinal study followed 188 infants (full-term and preterm).
- Infants were categorized by neonatal medical status and neurologic development (normal, suspect, abnormal).
- Cognitive, school performance, and socioeconomic status were assessed up to 8 years of age.
Main Results:
- Preterm infants with neonatal complications showed significant neurologic fluctuations.
- 45% of preterm infants with initial neurologic abnormality remained abnormal at 8 years.
- Neurologically normal children had better cognitive scores; abnormal preterm infants required more academic support and had lower achievement in reading and math.
Conclusions:
- Neonatal morbidities significantly affect neurologic outcomes in preterm children.
- Compromised neurologic status adversely impacts cognitive and school performance.
- Neonatal medical status is a key predictor of neurocognitive and school outcomes in low birth weight infants.
Objective:
The purpose of this prospective longitudinal study was to examine neurocognitive and school performance outcomes of low birth weight infants with reference to neonatal morbidity and socioeconomic status. We further evaluated the cognition and school performance based on their neurologic status at the time of assessment.
Methods:
One hundred eighty-eight children (39 healthy full-term and 149 preterm infants) were classified into 4 subgroups based on their neonatal medical status: healthy, sick (without neurologic complications), small for gestational age, and neurologically compromised infants. Neurologic status was classified as normal, suspect, or abnormal at hospital discharge, 18 months, 30 months, 4 years, and 8 years of age. Socioeconomic status, cognitive, and school performances were assessed.
Results:
Neurologically, both full-term and healthy preterm groups did well during the 8-year period. There were significant fluctuations between suspect and abnormal neurologic classifications among the 3 preterm groups with neonatal complications. Preterms with neurologic abnormality during the neonatal period did the poorest with 45% of the group remaining abnormal at 8 years of age. Children who were neurologically normal had higher cognitive scores at ages 4 and 8 than those categorized as suspect or abnormal. Preterm infants with neurologic abnormality required significantly more academic resources in the school. Reading and math achievement scores were the lowest for the preterm groups classified as neurologically suspect or abnormal.
Conclusions:
Neonatal morbidities exert a significant impact in neurologic outcomes among preterm children during the 8 years of assessment. Compromised neurologic status adversely affects cognitive and school performances. Neonatal medical status is an important variable indicating neurocognitive and school performance outcomes in low birth weight infants.
