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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental outcome over time of preterm born children ≤750 g at birth
M J Claas1, L S de Vries, H W Bruinse
1Department of Obstetrics, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, The Netherlands. m.j.claas@umcutrecht.nl
Insights
Extremely low birth weight infants often face cognitive challenges. A normal neurodevelopmental outcome at 2 years corrected age reliably predicts later outcomes, while delayed outcomes may improve over time.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Pediatric Neurology
Background:
- Extremely low birth weight (ELBW) infants are susceptible to cognitive impairments.
- Long-term neurodevelopmental outcome (NDO) monitoring is crucial for ELBW survivors.
- The optimal age for predicting NDO in ELBW infants remains debated.
Purpose of the Study:
- To characterize NDO at 2, 3.5, and 5.5 years in a cohort of ELBW infants.
- To assess the predictive value of NDO at 2 years corrected age (CA) for later NDO at 3.5 and 5.5 years.
Main Methods:
- Retrospective cross-sectional and longitudinal cohort study design.
- Included 101 ELBW infants (birth weight ≤750g) born between 1996-2005.
- NDO assessed using age-appropriate tests, categorized as normal (Z-score≥-1), mildly delayed (-2≤Z-score<-1), or severely delayed (Z-score<-2).
Main Results:
- Normal NDO was observed in 74.3% at 2 years, 82.2% at 3.5 years, and 76.2% at 5.5 years.
- A normal NDO at 2 years CA predicted normal NDO at 3.5 years (92%) and 5.5 years (84%).
- Most children with delayed NDO at 2 years CA showed improvement by 3.5 years (69.2%) and 5.5 years (65.4%).
Conclusions:
- The majority of ELBW infants (BW≤750g) achieve normal NDO across all assessed ages.
- Normal NDO at 2 years CA is a strong predictor of sustained normal neurodevelopment.
- Delayed NDO at 2 years CA is often transient, with significant improvement observed by 3.5 and 5.5 years.
Background:
Extremely low birth weight (ELBW) infants are at risk of cognitive impairment and follow-up is therefore of major importance. The age at which their neurodevelopmental outcome (NDO) can reliably be predicted differs in the literature.
Aims:
To describe NDO at 2, 3.5 and 5.5 years in an ELBW cohort. To examine the value of NDO at 2 years corrected age (CA) for prediction of NDO at 3.5 and 5.5 years.
Study Design:
A retrospective cross-sectional and longitudinal cohort study.
Subjects:
101 children with a BW≤750 g, born between 1996 and 2005, who survived NICU admission and were included in a follow-up program.
Outcome Measures:
NDO, measured with different tests for general development and intelligence, depending on age of assessment and classified as normal (Z-score≥-1), mildly delayed (-2≤Z-score<-1) or severely delayed (Z-score<-2).
Results:
At 2, 3.5 and 5.5 years 74.3, 82.2 and 76.2% had a normal NDO. A normal NDO at 2 years CA predicted a normal NDO at 3.5 and 5.5 years in 92% and 84% respectively. Of the children with a mildly or severely delayed NDO at 2 years CA the majority showed an improved NDO at 3.5 (69.2%) and 5.5 years (65.4%) respectively.
Conclusions:
The majority of the children with a BW≤750 g had a normal NDO at all ages. A normal NDO at 2 years CA is a good predictor for normal outcome at 3.5 and 5.5 years, whereas a delayed NDO at 2 years CA is subject to change with the majority of the children showing a better NDO at 3.5 and 5.5 years.
