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Updated: Mar 17, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Neurodevelopmental outcome at 3 years of age of infants born at less than 26 weeks]
Insights
Favorable neurodevelopmental outcomes at age 3 in extremely preterm infants are linked to shorter mechanical ventilation and prenatal corticosteroid use. These findings highlight the importance of optimizing perinatal care for high-risk newborns.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Perinatal Medicine
Background:
- Decreasing mortality rates in extremely preterm infants raise concerns about long-term neurodevelopmental outcomes.
- Understanding factors influencing favorable outcomes is crucial for this high-risk population.
Purpose of the Study:
- To describe the neurodevelopmental status of extremely preterm children at 3 years of age.
- To identify perinatal factors associated with a lack of disability in this cohort.
Main Methods:
- Infants born before 26 weeks gestation (2007-2011) in a French network were included.
- Perinatal data and neonatal morbidities were collected.
- Neurodevelopmental assessments were performed at 3 years, with disability classified as none, moderate, or severe. Logistic regression identified associated perinatal factors.
Main Results:
- Of 101 survivors, 66 were assessed at 3 years; 56% had no disability, 6% had severe disability, and 13% had cerebral palsy.
- Short duration of mechanical ventilation (OR=0.96) and complete prenatal corticosteroid treatment (OR=4.7) were associated with no disability.
- Survival rates increased with gestational age.
Conclusions:
- Improving perinatal care is essential to enhance long-term outcomes for extremely preterm infants.
- Specific interventions like minimizing mechanical ventilation and ensuring prenatal corticosteroid use may positively impact neurodevelopment.
Objective:
To describe the neurodevelopmental outcome and perinatal factors associated with favorable outcome among extremely preterm children at 3 years of age.
Methods:
All infants born before 26 weeks of gestation between 2007 and 2011, admitted to intensive care units participating in a French regional network (western PACA-southern Corsica) were included. Perinatal data were collected to assess the main neonatal morbidities. At 3 years of age, the children's neurodevelopment was assessed by trained physicians participating in the follow-up network. Children were classified according to their disability: none, moderate, or severe. Using logistic regression, we determined the perinatal factors associated with the absence of disability at 3 years of age.
Results:
One hundred and sixty-two very preterm newborns were admitted to neonatal intensive care units. At discharge the survival rate was 62% (101). Rates of survival increased with gestational age (33% at 23 weeks, 57% at 24 weeks and 68% at 25 weeks). Among the 101 surviving extremely preterm children, 66 were evaluated at 3 years. The perinatal characteristics were not significantly different from those of the children lost to follow-up. Overall, 56% of extremely preterm children had no disability and 6% had severe disability. Cerebral palsy was diagnosed in 13% of children. At 3 years of age, the main perinatal factors associated with no disability were short duration of mechanical ventilation (OR=0.96 [0.93-0.99]; P=0.03) and complete course of prenatal corticosteroids (OR=4.7 [1.2-17.7]; P=0.02).
Conclusion:
As mortality rates continue to decrease for very preterm infants, concerns are rising about their long-term outcome. In this high-risk population, improving perinatal care remains a challenge to improve long-term outcome.
