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Updated: May 15, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Perinatal brain injury, visual motor function and poor school outcome of regional low birth weight survivors at age
Jun Zhang1, Ashley Darcy Mahoney, Jennifer A Pinto-Martin
1HOPE School of Nursing, Wuhan University HOPE, Wuhan, China. catherinezhang2010@126.com
Insights
Perinatal brain injury in low birth weight infants significantly impacts long-term school outcomes, affecting reading and math abilities. Early monitoring is crucial for neurodevelopmental disabilities and improving school performance.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Educational Psychology
Background:
- Limited understanding of school outcome mechanisms in low birth weight (LBW) survivors.
- Investigating the link between perinatal brain injury and academic challenges in LBW infants.
Purpose of the Study:
- To examine the relationship between perinatal brain injury, visual motor function (VMF), and school performance in LBW survivors.
- To determine if VMF mediates the association between brain injury and academic outcomes.
Main Methods:
- Secondary analysis of data from 777 LBW infants (birth weight ≤ 2000 g) from a 1984-1987 cohort.
- Assessed school outcomes at age 9 using the Woodcock-Johnson Academic Achievement Scale.
- Quantified perinatal brain injury severity via neonatal cranial ultrasounds at 4 hours, 24 hours, and 7 days.
Main Results:
- 17.5% of LBW survivors experienced poor school performance (below 1 SD from average).
- Severe perinatal brain injury (PL/VE) correlated with significantly lower math and reading scores.
- Visual motor function significantly impacted overall school performance, including reading and math subtests, but did not mediate the brain injury-school outcome link.
Conclusions:
- Perinatal brain injury has a lasting negative effect on academic achievement in LBW infants.
- Close monitoring of LBW infants with perinatal brain injury is essential to mitigate poor school outcomes and other neurodevelopmental issues.
Aims And Objectives:
To explore the relationship between perinatal brain injury, visual motor function (VMF) and poor school outcome.
Background:
Little is known about the status and underlying mechanism of poor school outcome as experienced by low birth weight survivors.
Design:
This is a secondary data analysis.
Methods:
The parental study recruited 1104 low birth weight (LBW) infants weighing ≤ 2000 g from three medical centres of Central New Jersey between 1984 and 1987. Seven hundred and seventy-seven infants survived the neonatal period, and their developmental outcomes had been following up regularly until now. The development data of the survivors were used to achieve the research aims. Initial school outcome assessment was carried out in 9-year-old, using the Woodcock-Johnson Academic Achievement Scale. The severity and range of perinatal brain injury was determined by repeated neonatal cranial ultrasound results obtained at 4 hours, 24 hours and 7 days of life.
Results:
Seventeen and a half per cent of the sample experienced poor school performance at age 9 as defined by lower than one standard deviation (SD) of average performance score. Children with the most severe injury, PL/VE, had the lowest mathematics (F = 14·54, p = 0·000) and reading (anova results: F = 11·56, p = 0·000) performances. Visual motor function had a significant effect on children's overall school performance (Hotelling's trace value was 0·028, F = 3·414, p = 0·018), as well as subtest scores for reading (p = 0·006) and mathematics (p = 0·036). However, visual motor function was not a mediator in the association of perinatal brain injury and school outcome.
Conclusions:
Perinatal brain injury had a significant long-term effect on school outcome.
Relevance To Clinical Practice:
Low birth weight infants with history of perinatal brain injury need be closely monitored to substantially reduce the rates of poor school outcome and other neurodevelopmental disabilities.
