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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

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Neurobehaviour at term-equivalent age and neurodevelopmental outcomes at 2 years in infants born moderate-to-late

Alicia J Spittle1,2,3, Jennifer M Walsh2,3,4, Cody Potter2

  • 1Department of Physiotherapy, University of Melbourne, Melbourne, Vic, Australia.

Developmental Medicine and Child Neurology
|October 25, 2016
PubMed

Insights

Newborn neurobehavioral assessments can predict later development in moderate-to-late preterm infants. Suboptimal scores on exams like the HNNE and NNNS indicate higher risks for cognitive, language, and motor delays at two years old.

Area of Science:

  • Neonatal neurology
  • Developmental pediatrics
  • Perinatal medicine

Background:

  • Moderate-to-late preterm (MLPT) infants (32-36 weeks' gestation) face increased risks for neurodevelopmental challenges.
  • Early identification of neurodevelopmental risks in MLPT infants is crucial for timely intervention.

Purpose of the Study:

  • To investigate the association between newborn neurobehavioral assessments and neurodevelopmental outcomes at 2 years corrected age in MLPT infants.
  • To determine if specific suboptimal scores on neonatal neurobehavioral exams predict later developmental delays.

Main Methods:

  • A cohort of 201 MLPT infants underwent the Hammersmith Neonatal Neurological Examination (HNNE) and NICU Network Neurobehavioral Scale (NNNS) assessments.
  • Neurodevelopmental outcomes (cognitive, language, motor) were evaluated at 2 years corrected age using the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III).
  • Linear regression analyses examined the relationship between term neurobehavior and 2-year Bayley-III scores, defining suboptimal performance as scores below the 10th centile and delay as below 1 standard deviation.

Main Results:

  • Suboptimal HNNE total scores were linked to a 2.66-fold increased odds of cognitive delay.
  • Suboptimal NNNS scores for excitability (OR 3.01) and lethargy (OR 4.05) were significantly associated with cognitive delay.
  • Suboptimal NNNS lethargy scores also increased the odds of language delay (OR 5.64) and motor delay (OR 6.86).

Conclusions:

  • Specific suboptimal findings on newborn neurobehavioral assessments, particularly on the HNNE and NNNS, are associated with neurodevelopmental delays at two years in MLPT infants.
  • These findings highlight the predictive value of early neurobehavioral assessments for identifying MLPT infants at risk for developmental impairments.
Abstract

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