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Updated: Jul 11, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Outcome at 3 years of age in a population-based cohort of extremely preterm infants
Isabel De Groote1, Piet Vanhaesebrouck, Els Bruneel
1Research Group Developmental Disabilities, Ghent University, Ghent, Belgium.
Insights
Outcomes for extremely preterm infants are generally poor, with a significant percentage experiencing developmental impairments. Identifying early predictors of adverse outcomes remains a critical challenge for neonatal care.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Public Health
Background:
- Infants born at 26 weeks gestation or earlier face significant health risks.
- Long-term neurodevelopmental outcomes for extremely preterm infants require thorough assessment.
Purpose of the Study:
- To evaluate the health and neurodevelopmental status at 3 years of age in extremely preterm infants.
- To analyze outcomes in a geographically defined cohort of neonatal intensive care unit (NICU) survivors.
Main Methods:
- Clinical examination and standardized neurodevelopmental assessments were performed.
- International criteria were used to define disabilities.
- Data on overall disability were collected for 97% of surviving children.
Main Results:
- 36% of assessed children had deficient neuromotor development; 5% had severe sensory-communicative impairment.
- 70% exhibited mental or psychomotor impairment (more than 1 standard deviation below the mean).
- Overall poor outcome (death or disability) was estimated at 58% for surviving infants.
Conclusions:
- Extremely preterm infants show poor average developmental outcomes.
- Developing methods for early prediction of adverse outcomes is essential.
Objective:
To assess health and neurodevelopmental outcome at 3 years of age in neonatal intensive care unit (NICU)-surviving children who were born at 26 or fewer weeks of gestation in a geographically defined region of Belgium from 1999 through 2000.
Methods:
The study included a clinical examination and a standardized neurologic and developmental assessment. Disabilities were defined by international criteria. In 97% (92 of 95) of the children, accurate information on the presence of overall disability could be collected.
Results:
Thirty-six percent (95% confidence interval [CI] 25-47%) of the formally assessed children (28 of 77) had deficient neuromotor development, with 5% of them showing severe sensory-communicative impairment. Mean (+/-standard deviation) scores on the Mental Developmental Index and Psychomotor Developmental Index were 81.2 (18.8) and 73.2 (17.8), respectively. Seventy percent (95% CI 60-80%) had a mental (Mental Developmental Index) or psychomotor (Psychomotor Developmental Index) impairment or both, assessed to be more than 1 standard deviation below the population mean. Mental and psychomotor outcome did not differ significantly when compared according to either gestational age, gender, or multiple birth (all P>.05). When either minor central dysfunction or cerebral palsy was not taken into account, normal mental development was recorded in 62% of the subjects. The cumulative of poor outcome (ie, disability- or prematurity-related death) among the 95 infants discharged alive was estimated to be 58% (95% CI 48-68%), representing 25 (26%) mildly-to-moderately disabled and 28 (29%) severely disabled toddlers, including two infants whose postdischarge deaths were directly related to prematurity.
Conclusion:
The average developmental outcome is poor in children born as extremely preterm infants. Finding early predictors of adverse outcome is a major challenge.
