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Updated: May 17, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Early detection of minor neurodevelopmental dysfunctions at age 6 months in prematurely born neonates
Jen-Fu Hsu1, Ming-Horng Tsai, Shih-Ming Chu
1Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Insights
Minor neurological dysfunctions (MNDs) affect 13.2% of premature infants by 6 months corrected age. Risk factors include low birth weight, postnatal corticosteroid use, and cholestasis, with outcomes worsening with earlier gestation.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Neuroscience
Background:
- Premature birth poses risks for infant neurodevelopment.
- Early identification of neurodevelopmental issues is crucial for timely intervention.
- Minor neurological dysfunctions (MNDs) can impact long-term development.
Purpose of the Study:
- To investigate the 6-month neurodevelopmental outcomes of prematurely born neonates.
- To identify neonatal factors associated with minor neurological dysfunctions (MNDs).
Main Methods:
- Prospective data collection on 151 infants born before 37 weeks gestation.
- Assessment at 6 months corrected age using Bayley Scales of Infant Development-2nd Edition (BSID-II) and Denver Developmental Screening Test (DDST).
Main Results:
- 20 (13.2%) neonates exhibited MNDs at 6 months corrected age.
- MND prevalence was higher in infants born earlier (21.6% for <28 weeks gestation).
- Low birth weight (<1000g), postnatal corticosteroid use (OR 11.2), and cholestasis (OR 6.2) were associated with MNDs.
Conclusions:
- MNDs are detectable as early as 6 months corrected age in premature infants, including those born at 33-36 weeks gestation.
- Neurodevelopmental risk increases with decreasing gestational age.
- BSID-II and DDST are reliable tools for assessing MNDs in this population.
Objective:
To investigate the 6-month neurodevelopmental outcomes of prematurely born neonates and find the determining neonatal factors of minor neurological dysfunctions (MNDs).
Study Design:
We examined data collected prospectively on 151 infants born before 37th week of gestation in 2009-2010 who were assessed at 6 months corrected age with the Bayley Scales of Infant Development-2nd Edition (BSID-II) and the Denver Developmental Screening Test (DDST).
Results:
Of 151 neonates born before 37 weeks, 20 (13.2%) had MNDs at 6 months corrected age. These proportions were 21.6%, 13.2%, and 8.2% for neonates born before 28 weeks, 29 weeks to 32 weeks, and 33 weeks to 36 weeks, respectively. Half of neonates with MNDs have a birth body weight of less than 1000g. BSID-II and DDST are highly correlated in assessing the MNDs of premature neonates at 6 months corrected age. MND was independently associated with postnatal corticosteroid use (odds ratio [OR], 11.2; 95% confidence interval [CI], 1.9-66.0, P=0.008) and cholestasis (OR, 6.2; 95% CI, 1.16-33.1, P=0.033).
Conclusions:
Premature neonates, even those born at 33 to 36 weeks, are found to have MNDs as early as 6 months corrected age by BSID-II and DDST, with risk increasing as gestation decreases.
