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Updated: Mar 29, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Using cluster analysis to provide new insights into development of very low birthweight (VLBW) premature infants
Gail S Ross1, L M Foran1, Baptiste Barbot2
1Newborn Medicine, Weill-Cornell Medical College, Box 106, 525 East 68 Street, New York, NY 10021, USA.
Insights
This study identified four developmental profiles in very low birthweight (VLBW) infants, linking factors like socioeconomic status and medical conditions to these outcomes. This helps predict future development and guide early intervention for VLBW children.
Area of Science:
- Neonatal development
- Pediatric neurology
- Developmental psychology
Background:
- Existing follow-up studies for very low birthweight (VLBW) premature infants often focus on single developmental outcomes.
- There is a need to assess comprehensive developmental profiles in this vulnerable population.
Purpose of the Study:
- To identify distinct developmental profiles in VLBW infants using cognitive and language assessments.
- To investigate associations between these profiles and demographic, perinatal, and behavioral factors.
Main Methods:
- Retrospective chart review of 117 VLBW infants assessed at 18 months corrected age.
- Utilized Bayley Scales-III (Cognitive, Expressive Language, Receptive Language) and Child Behavior Checklist (CBCL 1 ½-5).
- Cluster analysis grouped infants based on cognitive and language scores; demographic, perinatal, and behavioral data were analyzed for associations.
Main Results:
- Four developmental profiles were identified: Consistently High, Consistently Average, Average with Delayed Expressive Language, and Consistently Low.
- Socioeconomic status, bronchopulmonary dysplasia, severe intraventricular hemorrhage (Grades III-IV), and behavioral problem scores (including ADHD) were significantly associated with these profiles.
Conclusions:
- Cluster analysis effectively defined distinct developmental outcome groups in VLBW children.
- This approach aids in identifying factors influencing developmental outcomes and may predict later development.
- The findings can inform early intervention strategies for specific at-risk groups of VLBW infants.
Background:
Very low birthweight (VLBW) premature infant follow-up studies report on single developmental outcome variables but do not assess profiles of development.
Aims:
To identify developmental profiles of VLBW premature infants based on cognitive and language development and their association with demographic, perinatal, and behavior variables.
Study Design:
Retrospective chart review.
Subjects:
117 children<1250 g BW seen at 18 months post-term on the Bayley Scales-III and Child Behavior Checklist 1 ½-5 (CBCL 1 ½-5), a behavior problem questionnaire. Demographic and perinatal variables were obtained from medical records.
Outcome Measures:
Bayley Cognitive, Expressive Language, and Receptive Language scores were used to cluster the subjects into developmental profiles. Demographic, perinatal, and CBCL variables were analyzed as they related to clusters.
Results:
Children were clustered into 4 groups based on their Bayley Cognitive, Expressive Language, and Receptive Language scores: Consistently High, Consistently Average, Average with Delayed Expressive Language, and Consistently Low. Socioeconomic status, bronchopulmonary dysplasia, Grades III-IV intraventricular hemorrhage, and summary Behavior Problems and Attention Deficit/Hyperactivity (ADHD) Problems scores were significantly related to clusters.
Conclusion:
Cluster analysis defined distinct outcome groups in VLBW premature children and provides an informative means of identifying factors related to developmental outcome. This approach may be useful in predicting later outcome and determining which groups of children will require early intervention.
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