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Updated: Dec 22, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Developmental trajectories of infants born at less than 30 weeks' gestation on the Bayley-III Scales
Chloe Durrant1, Hilary S Wong2, Tim J Cole3
1Cognitive Neuroscience and Neuropsychiatry Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.
Insights
The rate of development, not a single assessment, best predicts developmental trajectories in very preterm infants. Lower gestational age, birth weight, and male sex are linked to slower development rates.
Area of Science:
- Neonatal Development
- Developmental Pediatrics
- Perinatal Medicine
Background:
- Very preterm infants (<30 weeks' gestation) exhibit diverse developmental trajectories.
- Early identification of developmental risks is crucial for timely intervention.
- Standardized assessments like the Bayley Scales of Infant and Toddler Development (Bayley-III) are used to track development.
Purpose of the Study:
- To characterize cognitive, language, and motor developmental trajectories in very preterm infants.
- To identify perinatal factors influencing these developmental trajectories.
Main Methods:
- Utilized data from 1142 infants born <30 weeks' gestation.
- Applied Super Imposition by Translation and Rotation (SITAR) growth curve analysis to Bayley-III scores at 3, 6, 12, and 24 months corrected age.
- Modeled cognitive, receptive/expressive language, and fine/gross motor development.
Main Results:
- SITAR models successfully explained significant variance in cognitive (62%), receptive communication (68%), fine motor (53%), and gross motor (68%) development.
- The rate of development (curve gradient) was the primary predictor of developmental trajectories across domains.
- Lower gestational age, lower birth weight, and male sex were associated with slower developmental rates.
Conclusions:
- The rate of development is a more robust predictor of very preterm infant trajectories than single time-point assessments.
- Monitoring developmental rate is essential for early intervention strategies in this population.
Objective:
To describe the cognitive, language and motor developmental trajectories of children born very preterm and to identify perinatal factors that predict the trajectories.
Design:
Data from a cohort of 1142 infants born at <30 weeks' gestation who were prospectively assessed on the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III) at 3, 6, 12 and 24 months corrected age, were analysed using the Super Imposition by Translation and Rotation (SITAR) growth curve analysis model.
Main Outcome Measures:
Developmental trajectory SITAR models for Bayley-III cognitive, language (receptive and expressive communication subscales) and motor (fine and gross motor subscales) scores.
Results:
The successfully fitted SITAR models explained 62% of variance in cognitive development, 68% in receptive communication, 53% in fine motor and 68% in the gross motor development. There was too much variation in the expressive communication subscale to fit a SITAR model. The rate of development (gradient of the curve) best explains the variation in trajectories of development in all domains. Lower gestational age, lower birth weight and male sex significantly predicted a slower rate of development.
Conclusion:
The rate of development, rather than single time point developmental assessment, best predicts the very preterm infant's developmental trajectory and should be the focus for monitoring and early intervention.
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