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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

Early-childhood neurodevelopmental outcomes are not improving for infants born at <25 weeks' gestational age

Susan R Hintz1, Douglas E Kendrick, Deanne E Wilson-Costello

  • 1Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Rd, Suite 315, Palo Alto, CA 94304, USA. srhintz@stanford.edu

Pediatrics
|December 29, 2010
PubMed

Insights

Neurodevelopmental outcomes for extremely low birth weight infants born before 25 weeks

Area of Science:

  • Neonatalogy
  • Developmental Pediatrics
  • Perinatology

Background:

  • Extremely low birth weight infants (born <25 weeks estimated gestational age) face significant neurodevelopmental challenges.
  • Changes in neonatal care practices may impact outcomes over time.

Purpose of the Study:

  • To compare neurodevelopmental outcomes at 18 to 22 months corrected age for infants born extremely prematurely.
  • To assess changes in outcomes between two distinct care epochs (1999-2001 and 2002-2004).

Main Methods:

  • Retrospective multicenter analysis using Neonatal Research Network data.
  • Comparison of perinatal and neonatal variables between the two epochs.
  • Neurodevelopmental assessment using neurologic exams and Bayley Scales of Infant Development II.

Main Results:

  • Infant survival rates were similar between epochs (35.4% vs 32.3%).
  • Cesarean delivery, patent ductus arteriosus surgery, and late sepsis increased in the later epoch.
  • Postnatal steroid use significantly decreased (63.5% vs 32.8%).
  • Adverse neurodevelopmental outcomes, including cerebral palsy and low Mental Developmental Index scores, remained common and showed no significant change between epochs.

Conclusions:

  • Despite changes in care practices like reduced postnatal steroid use, early-childhood neurodevelopmental outcomes for extremely preterm infants (<25 weeks GA) did not significantly improve between the two study periods.
  • Continued research is needed to identify interventions that can improve long-term neurodevelopmental trajectories in this vulnerable population.
Abstract

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