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Updated: Aug 9, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Long-term prognosis for premature infants]
1Service de pédiatrie, Centre hospitalier universitaire vaudois, Lausanne.
Insights
Very low birth weight (VLBW) infants have improved survival, but long-term neurodevelopmental outcomes require monitoring. Early detection of abnormalities in VLBW survivors is crucial for intervention and better outcomes.
Area of Science:
- Neonatology
- Neurodevelopmental Pediatrics
- Perinatal Medicine
Context:
- Advances in perinatology have reduced perinatal mortality in very low birth weight (VLBW) infants.
- Comprehensive follow-up programs are essential for assessing the long-term effects of neonatal intensive care.
Purpose:
- To evaluate the role of sequential brain ultrasonography and serial neurological assessments in predicting neurodevelopmental outcomes in VLBW infants.
- To determine the incidence of major and minor neurodevelopmental abnormalities at school age in VLBW survivors.
Summary:
- Sequential brain ultrasonography and neurological assessments during the neonatal period are important for predicting later neurodevelopmental outcomes in VLBW infants.
- Major sequelae are linked to periventricular leukomalacia and extensive parenchymal hemorrhage.
- At 8 years of age, 17% of VLBW infants exhibited minor neurodevelopmental abnormalities, with school failure associated with multiple issues.
Impact:
- Improved understanding of cerebral damage pathophysiology leads to more effective preventive measures.
- The incidence of major handicaps in VLBW survivors is decreasing.
- Early detection of neurodevelopmental problems allows for timely parental counseling and intervention, improving outcomes for VLBW infants.
Abstract:
Recent advances in perinatology have been associated with a decrease in perinatal mortality among very low birth weight (VLBW) infants. However, only comprehensive follow-up programmes allow obstetricians and neonatologists to measure short-term and long-term effects of neonatal intensive care. In our experience, sequential brain ultrasonography together with serial neurological assessments during the neonatal period play an important role in the prediction of later neurodevelopmental outcome. Major sequelae are closely related to periventricular leukomalacia and extensive parenchymal haemorrhage. With improving knowledge of the physiopathology of cerebral damage, more effective preventive measures are now being taken. Nowadays, the incidence of major handicaps (5%) is steadily decreasing among VLBW survivors. Only a few comprehensive studies have regularly followed up preterm infants until school age. Our results showed that 17% of VLBW infants had minor neurodevelopmental abnormalities (visuomotor or motor disorders and language disorders) at 8 years of age. School failure was frequently found among children who presented the association of several neurodevelopmental abnormalities. Most of these developmental problems can be detected in preschool age, and early recognition may allow better counselling of parents and appropriate intervention. An optimistic attitude regarding the outcome in VLBW infants without cerebral lesions or associated neurodevelopmental abnormalities is certainly justified at the present time. These results emphasize the importance of optimal perinatal intensive care for VLBW infants.
