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Updated: Jun 2, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[2-year follow-up examinations (Bayley II) in infants born at <32 weeks in a German perinatal center]
1Department of Neonatology, Tübingen University Hospital, Calwerstraße 7, Tübingen.
Insights
Follow-up examinations for very low birth weight infants improved significantly after 2006, with increased participation rates and a low incidence of severe impairments. Bayley II test results remained consistent, indicating reliable developmental assessments.
Area of Science:
- Neonatal care and developmental pediatrics.
- Longitudinal studies of high-risk infants.
- Public health policy impact on infant follow-up.
Context:
- Germany mandated 2-year follow-up for very low birth weight (VLBW) infants using the Bayley II test in 2008.
- This study retrospectively analyzed developmental outcomes before and after the mandate.
- Data from 2004-2007 included 372 VLBW infants discharged alive from a single center.
Purpose:
- To compare the completeness of developmental follow-up examinations before and after the introduction of obligatory testing for VLBW infants.
- To assess the impact of the mandatory follow-up policy on examination rates and developmental outcomes.
- To evaluate the rate of severe impairments and developmental trajectories in VLBW infants.
Summary:
- Follow-up participation increased from 64% to 84% after the introduction of obligatory 2-year examinations.
- 75% of infants demonstrated normal development; 4% had severe impairments (2% cerebral palsy, 1% blind, 1% deaf).
- The mean Mental Development Index (MDI) was 100.3, with no significant changes in test results post-mandate.
Impact:
- The study demonstrates improved follow-up completeness for VLBW infants due to policy changes.
- Findings suggest a relatively low rate of severe impairments among VLBW infants compared to international data.
- The consistent Bayley II test results indicate the reliability of developmental assessments in this cohort.
Background:
Since 2008, follow-up examinations at 2 years of age with the standardized Bayley II test have become obligatory in Germany for all very low birth weight infants.
Aim:
We already performed such examinations before 2006. Here, we compared our data and the completeness of our examinations before and after the introduction of the obligatory 2-year follow-up.
Patients:
From 2004-2007, 372 infants <1500 g or <32 weeks were discharged alive from our center, 19 infants died during their initial hospital stay, 2 after discharge.
Results:
271 patients participated in the follow-up examination at age 2 years, with the proportion of participating infants increasing from 64% to 84% after the introduction of obligatory tests. 75% of infants showed a normal development, while 4% had a severe impairment (defined as being blind (1), deaf (1) or having cerebral palsy (6), the CP rate thus being 2%). 49% of infants completed the Bayley test; the mean MDI was 100.3 (SD 10.6). There were no significant qualtitative differences in test results with the introduction of the obligatory test.
Conclusions:
The completeness of our follow-up increased over the years. In comparison with international data we found a low rate of severely impaired, deaf or blind VLBW infants.