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Updated: Aug 9, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental outcome at 2 years in 23 to 26 weeks old gestation infants
C Sommer1, B Urlesberger, U Maurer-Fellbaum
1Division of Neonatology, Department of Pediatrics, University Hospital, Graz, Austria.
Insights
Developmental delay is common in extremely preterm infants born before 27 weeks gestational age. Neurologic impairments and growth failure also affect a significant proportion of these high-risk infants.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- High-risk infant follow-up
Background:
- Extremely preterm infants (gestational age <27 weeks) born between 1996-2001 were assessed.
- Focus on neurologic and developmental outcomes at 2 years of age.
Purpose of the Study:
- To evaluate the neurologic and developmental status of infants born extremely preterm.
- To assess growth parameters in this vulnerable population.
Main Methods:
- Follow-up of 110 infants with gestational age <27 weeks.
- Neurologic examination and cerebral palsy classification (GMFCS) at 1 and 2 years.
- Griffith Mental Development Scales assessed at 2 years.
- Growth measurements at birth, 1, and 2 years.
Main Results:
- Mortality rate was 52%.
- At 2 years, 90% had normal neurology, but 64% had overall disability, with 27% severe disability.
- Developmental delay was prevalent: 19% severe delay, 35% moderate delay.
- Growth failure (<3rd centile) affected 39% for weight and 19% for head circumference.
Conclusions:
- Developmental delay is highly common in extremely preterm infants (<27 weeks GA).
- Developmental issues exceed the prevalence of neurological disabilities, including cerebral palsy.
- Significant rates of neurologic impairment and growth failure highlight the challenges faced by this cohort.
Background:
Assessment of neurologic and developmental outcome at 2 years age of infants with gestational age (GA)<27 weeks, born between 1996-2001.
Patients:
A total of 110 live-born preterm infants with GA<27 weeks.
Methods:
Main outcome criterions: Neurologic examination (according to Touwen) and classification of cerebral palsy by using the Gross Motor Function Classification System (GMFCS) at the corrected age of 1 and 2 years; assessment of mental and psychomotor development by using the Griffith Mental Development scales at the corrected age of 2 years; growth assessment at birth, 1 and 2 years.
Results:
Mortality was 52%. Regular follow up was performed in 48 (91%) of the 53 surviving infants. Neurologic outcome: at 1 year age: 2% nonambulant cerebral palsy, 25% mild neurologic signs and 73% normal; at 2 years age: 4% nonambulant cerebral palsy, 2% ambulant cerebral palsy, 4% mild neurologic signs and 90% normal neurology. Developmental outcome at 2 years age: 40% DQ>-1 SD, 6% DQ between -1 SD and -2 SD (mild delay), 35% DQ between -2 SD and -3 SD (moderate delay) and 19% DQ<-3 SD (severe delay). Overall disability was found in 64%, severe disability in 27% of the infants. Profound growth failure in weight and head circumference<3rd centile at 2 years age was recorded in 39 and 19% of the infants, respectively.
Conclusion:
Developmental delay is very common in preterm infants<27 GA and exceeds the number of neurological disabilities (including cerebral palsy).
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