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Updated: Jun 22, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Quality evaluation of a neuro-development follow-up program of very low birthweight infants]
T Agut Quijano1, N Conde Cuevas, M Iriondo Sanz
1Servicio de Neonatología, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain. tagut@hsjdbcn.org
Insights
This study found good adherence to neurodevelopmental follow-up quality indicators for very low birth weight (VLBW) infants. Evaluating these indicators helps improve VLBW infant developmental care programs.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Quality Improvement in Healthcare
Background:
- Advances in perinatology have improved survival rates for very low birth weight (VLBW; <1500 g) infants.
- VLBW infants face increased risks of neurological and developmental challenges.
- Quality indicators are recommended for neurodevelopmental follow-up programs for VLBW infants.
Purpose of the Study:
- To evaluate a neurodevelopmental follow-up program using established quality indicators.
- The analysis focused on five key areas: general care, physical health, sensory development (vision, hearing, speech, language), developmental/behavioral assessment, and psychosocial issues.
Main Methods:
- Retrospective study of 51 VLBW patients who completed a 6-year follow-up program.
- Assessed the program's adherence to recommended quality indicators.
Main Results:
- High adherence (92%) for discharge summaries; variable clinical data inclusion.
- Consistent somatometric evaluation and use of International Classification for Retinopathy of Prematurity (RDP).
- Most infants received timely evaluations for suspected handicaps, with high referral rates to neurodevelopment specialists, though program attrition and inconsistent psychosocial evaluations were noted.
Conclusions:
- The neurodevelopmental follow-up program demonstrates good adherence to most recommended quality indicators.
- Indicator evaluation is a valuable method for assessing and enhancing the quality of developmental follow-up programs for VLBW infants.
Introduction:
Advances in perinatology have been associated with improved survival of very low birth weight (VLBW;<1500 g) infants. These children have an increased risk of future neurological and development handicaps. A set of quality indicators have been recommended for the neurodevelopment follow-up programs in this group of patients.
Aim:
To analyze our neurodevelopment follow-up program according to these quality of care indicators in 5 post-discharge follow-up areas: general care; physical health; vision, hearing, speech and language; developmental and behaviour assessment; and psychosocial issues.
Patients And Methods:
Fifty-one VLWB patients born in 2000 who have completed our 6-year follow-up program have been retrospectively studied. The agreement between our program and the standard of quality is evaluated.
Results:
A copy of a discharge summary of the patient's neonatal course is present in the medical record in 92% of the cases. The inclusion of clinical data and general medical aspects in the medical summary is heterogeneous. Somatometric evaluation for the first two years of age is always present in a filled-in graphic. The international classification of the retinopathy of the preterm (RDP) is used in 100% of the patients. An ophthalmologic examination for RDP is performed in 72% (37/51) of the infants before hospital discharge; of the other 28%, only in 6 patients the date of the outpatient examination is present. Specific evaluations and interventions are performed within the recommended period of time in most of the children with suspected or neurosensory handicaps. More than ninety per cent of the patients are referred to the neurodevelopment specialist and most of them go to the visit (90.2% between 9 and 15 months and 78.4% between 21 and 30 months). Recommendations for a psycho-educational assessment are followed in the extremely premature (BW<1000 g and/or 28 weeks of gestational age) children. The number of patients who follow the program decreases with time. Psychosocial evaluation does not usually appear in the medical records of the patients.
Conclusion:
We have a good adherence to most of the recommended indicators in our follow-up program. The evaluation of these indicators is a useful tool to analyze the quality of a developmental follow-up program and to improve it.
