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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Twelve-month neurofunctional assessment and cognitive performance at 36 months of age in extremely low birth weight
Maria Lorella Giannì1, Odoardo Picciolini, Chiara Vegni
1Neonatal Intensive Care Unit, Institute of Pediatrics and Neonatology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena University Medical School, Milan, Italy. maria.gianni@unimi.it
Insights
An early neurofunctional assessment at 12 months can predict cognitive outcomes at 36 months in extremely low birth weight infants. This evaluation is a valuable tool for identifying children at risk for cognitive delay.
Area of Science:
- Neonatal Neurology
- Developmental Pediatrics
- Neuroscience
Background:
- Extremely low birth weight (ELBW) infants face increased risks for neurodevelopmental impairments.
- Early identification of cognitive deficits is crucial for timely intervention in ELBW populations.
- Predictive tools for cognitive outcomes in ELBW infants are essential for clinical practice.
Purpose of the Study:
- To determine if a neurofunctional assessment at 12 months' corrected age predicts cognitive outcome at 36 months' chronological age in ELBW infants.
- To evaluate the predictive value of early neurodevelopmental status for later cognitive performance in a vulnerable infant population.
Main Methods:
- An observational longitudinal study involving 141 ELBW children.
- Neurofunctional assessment conducted at 12 months' corrected age.
- Cognitive outcome assessed at 36 months' chronological age using the Griffiths Mental Developmental Scale.
Main Results:
- A significant association exists between 12-month neurofunctional status and 36-month cognitive performance.
- Infants with normal 12-month neurodevelopment had higher cognitive scores at 36 months compared to those with minor or major dysfunctions.
- A 12-month neurofunctional score of 2 or higher, abnormal term brain MRI, and chronic lung disease predicted cognitive delay at 36 months, even after adjusting for confounders.
Conclusions:
- The 12-month neurofunctional evaluation serves as a useful clinical tool for predicting later cognitive outcomes in ELBW children.
- Early neurofunctional assessment can aid in identifying ELBW infants who may benefit from targeted developmental support and monitoring.
Objective:
The objective of this study was to investigate whether an early neurofunctional assessment (at 12 months' corrected age) is predictive of cognitive outcome at 36 months of age in extremely low birth weight infants.
Methods:
We conducted an observational longitudinal study. Neurodevelopmental outcome by means of a neurofunctional assessment was evaluated at 12 months' corrected age and 36 months' chronological age in 141 extremely low birth weight children. Cognitive outcome was assessed with use of the Griffiths Mental Developmental Scale.
Results:
A significant association was found between the 12-month neurofunctional status and cognitive performance at 36 months. A higher general quotient on the Griffiths Mental Developmental Scale at 36 months was observed in infants who exhibited normal (score: < or = 1) neurodevelopment compared with children who exhibited minor (score: 2) and major (score: > or = 3) dysfunctions at the 12-month neurofunctional evaluation (99 +/- 6.8 vs 85.3 +/- 16.3 vs 57.3 +/- 22.0). A score of > or = 2 at the 12-month neurofunctional assessment, abnormal brain MRI results at term, and chronic lung disease remained predictive of cognitive delay at 36 months of age and also after adjustment for confounders.
Conclusions:
The 12-month neurofunctional evaluation may be an additional useful clinical tool in predicting later cognitive outcome in extremely low birth weight children.
