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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurobehavioral assessment predicts differential outcome between VLBW and ELBW preterm infants
Janet C Constantinou1, Elvidina N Adamson-Macedo, Majid Mirmiran
1Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
Insights
Birth weight impacts preterm infant development. Extremely low birth weight (ELBW) infants had lower neurobehavioral scores than very low birth weight (VLBW) infants, predicting later outcomes.
Area of Science:
- Neonatal Development
- Pediatric Neurodevelopment
- Perinatal Medicine
Background:
- Birth weight is a critical factor in preterm infant outcomes.
- Neurobehavioral assessments are vital for evaluating development in high-risk infants.
- Early identification of developmental trajectories is crucial for timely intervention.
Purpose of the Study:
- To assess the influence of birth weight on neurodevelopment in very low birth weight (VLBW) infants.
- To correlate predischarge neurobehavioral scores with long-term developmental outcomes.
- To examine the relationship between birth weight categories and neurodevelopmental assessments.
Main Methods:
- 113 preterm infants were evaluated using the Neurobehavioral Assessment of the Preterm Infant (NAPI) at 36 weeks postmenstrual age.
- Infants were categorized into extremely low birth weight (ELBW) (<1000 g) and VLBW (1000-1500 g) groups.
- Neurodevelopment was assessed at 12, 18, and 30 months using the Bayley Infant Neurodevelopmental Screener (BINS) and Bayley Scales of Infant Development.
Main Results:
- Extremely low birth weight (ELBW) infants demonstrated significantly lower NAPI scores compared to very low birth weight (VLBW) infants.
- Predischarge NAPI scores correlated with neurodevelopmental outcomes at 12, 18, and 30 months.
- Infants who developed cerebral palsy had markedly lower scores across all neurodevelopmental assessments (NAPI, BINS, Bayley).
Conclusions:
- The Neurobehavioral Assessment of the Preterm Infant (NAPI) administered before hospital discharge offers valuable predictive information on later neurodevelopmental outcomes.
- Birth weight is a significant determinant of neurodevelopmental trajectories in preterm infants.
- Early neurobehavioral screening can identify infants at risk for adverse developmental outcomes.
Objective:
To evaluate the impact of birth weight on development of very low birth weight (VLBW) infants using the Neurobehavioral Assessment of the Preterm Infant (NAPI) before hospital discharge, and to show the relation to follow-up outcomes at 12, 18 and 30 months of age.
Study Design:
In total, 113 preterm infants were assessed with the NAPI at 36 weeks postmenstrual age. Later, neurodevelopment was examined using the Bayley Infant Neurodevelopmental Screener (BINS) at 12 months and the Bayley Scales of Infant Development, at 18 and 30 months. The cohort was divided into two groups, based on birth weight, extremely low birth weight (ELBW) (<1000 g) and VLBW (1000 to 1500 g).
Results:
ELBW infants showed significantly lower NAPI scores compared with VLBW infants at 36 weeks. The predischarge NAPI scores correlated with the 12, 18 and 30 months scores when the ELBW infants continue to have lower performance than the VLBW infants. In all, 14 infants developed cerebral palsy. These infants had significantly lower NAPI, BINS and Bayley scores compared with all other preterm infants.
Conclusion:
NAPI before discharge provides clinically meaningful information related to later neurodevelopmental outcome.
