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Updated: May 16, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Risk assessment of pre-term infants]
Dieter J Ziegenhagen1, C Knippig
1Abteilung Medizinische Beratung, ERGO Versicherungsgruppe AG, Köln.
Insights
Preterm birth, occurring before 37 weeks, significantly increases risks for developmental issues and chronic diseases. Long-term studies show lasting health impacts into adulthood for these infants.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Public Health
Context:
- Preterm birth, defined as birth before 37 completed weeks of gestation, presents significant challenges for infant neurodevelopment and long-term health.
- Infants born extremely preterm (before 28 weeks) often require extensive medical support, with 85% needing interventions by age five.
- Even late preterm births (34-36 weeks) are linked to increased risks of developmental impairment and chronic conditions.
Purpose:
- To synthesize current understanding of the neurodevelopmental and somatic outcomes for premature infants.
- To highlight the long-term health consequences and risks associated with various stages of preterm birth.
- To inform insurance medicine and healthcare providers about the ongoing needs and risks of preterm survivors.
Summary:
- Preterm birth is associated with a spectrum of adverse outcomes, with risks generally decreasing as gestational age increases.
- Long-term follow-up into early adulthood reveals higher incidences of asthma, psychiatric disorders, hypertension, reduced insulin sensitivity, and lower exercise capacity in former preterm infants.
- While early childhood assessments have limited predictive value, preterm birth is linked to increased overall mortality extending into adulthood.
Impact:
- Provides critical data for insurance medicine regarding the long-term care needs and risks of preterm infants.
- Underscores the importance of continued monitoring and support for preterm survivors throughout their lives.
- Highlights the need for further research into the contribution of preterm-related risk factors to adult cardiovascular and pulmonary morbidity and mortality.
Abstract:
Pre-term birth occurs when a baby is born before 37 weeks of gestation are completed. Many recent publications on neurodevelopmental and somatic outcome parameters of premature infants are of interest for insurance medicine. Infants born before the 28th week are called extremely pre-term. When examined at five years, 85% had already received or still needed special treatment or support. The results of examinations in early childhood have quite a low predictive value for the further development of the child. In the very and moderately pre-term stages, long-term risks are continuously declining with the length of gravidity. Even "late pre-term" birth (34 to 36 weeks of gestation) is associated with a nearly doubled rate of developmental impairment and chronic disease in childhood and adolescence. Various studies performed in early adulthood showed that former pre-term infants suffered more often from asthma and psychiatric disorders. On average, they also had higher blood pressure, lower insulin sensitivity, and a reduced exercise capacity. It remains to be evaluated how much these risk factors contribute to cardiovascular or pulmonary morbidity and mortality later in life. At least, general mortality after preterm birth seems to be increased up to the oldest age group statistically evaluated up to now, i.e. 18 to 36 years.
