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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Consequences and risks of <1000-g birth weight for neuropsychological skills, achievement, and adaptive functioning

H Gerry Taylor1, Nancy Klein, Dennis Drotar

  • 1Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio 44106-6038, USA. hgt2@cwru.edu

Journal of Developmental and Behavioral Pediatrics : JDBP
|December 14, 2006
PubMed

Insights

Children born with extremely low birth weight (ELBW) face significant neurodevelopmental challenges. Early identification of risk factors like low birth weight and medical complications is crucial for improving outcomes.

Area of Science:

  • Pediatrics
  • Neurodevelopmental Pediatrics
  • Neonatology

Background:

  • Extremely low birth weight (ELBW) infants (<1000g) represent a vulnerable population requiring long-term follow-up.
  • Previous studies indicate potential neurodevelopmental deficits in ELBW survivors.

Purpose of the Study:

  • To evaluate the school-age outcomes of ELBW children.
  • To identify specific risk factors associated with poorer neurodevelopmental outcomes in ELBW survivors.

Main Methods:

  • A cohort of 219 ELBW children born between 1992-1995 was followed to a mean age of 8 years.
  • Neuropsychological skills, academic achievement, and adaptive behavior were assessed and compared to 176 normal birth weight (NBW) controls.
  • Risk factors including birth weight, cranial ultrasound, postnatal steroid therapy, necrotizing enterocolitis, and chronic lung disease were analyzed.

Main Results:

  • ELBW children demonstrated significantly worse outcomes across all assessed measures compared to NBW controls.
  • Lower executive function and memory scores in ELBW children were linked to lower birth weight (<750g), cranial ultrasound abnormalities, postnatal steroid use, and necrotizing enterocolitis.
  • Impaired motor skills were associated with chronic lung disease.
  • Neuropsychological deficits mediated the impact of neonatal risks on academic and adaptive functioning.

Conclusions:

  • ELBW survivors exhibit lasting neurodevelopmental consequences into school age.
  • Specific neonatal risk factors predict adverse neurodevelopmental outcomes, highlighting targets for intervention.
  • Early assessment of neuropsychological skills is vital for understanding and addressing the long-term effects of extreme prematurity.

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