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Updated: Oct 22, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Predictors of long-term neurodevelopmental outcomes of children born extremely preterm
Alicia J Spittle1, Deanne K Thompson2, Joy E Olsen3
1Department of Physiotherapy, University of Melbourne, Parkville, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, Parkville, Australia; Department of Physiotherapy and Newborn Services, The Royal Women's Hospital, Parkville, Australia.
Insights
Children born extremely preterm face significant neurodevelopmental challenges. Early identification of risk factors in newborns is crucial for timely intervention and improved long-term outcomes.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Neuroscience
Background:
- Children born extremely preterm (gestation <28 weeks) exhibit higher risks for neurodevelopmental issues compared to full-term infants.
- These challenges can manifest as cognitive, motor, and behavioral difficulties, impacting academic and health outcomes.
- Predicting these long-term outcomes is complex, necessitating a comprehensive approach.
Purpose of the Study:
- To review predictors of neurodevelopmental outcomes in extremely preterm infants.
- To highlight the importance of early assessment and intervention strategies.
Main Methods:
- Review of established predictors in the newborn period.
- Inclusion of perinatal factors, neuroimaging, neurobehavioral assessments, and socio-environmental influences.
- Synthesis of current evidence on risk assessment.
Main Results:
- Identified key predictors including perinatal complications, specific neuroimaging markers, and early neurobehavioral patterns.
- Emphasized the role of social and environmental factors in shaping outcomes.
- Highlighted the variability in neurodevelopmental trajectories.
Conclusions:
- Multi-disciplinary team assessment is vital for accurate risk stratification.
- Early identification of at-risk infants facilitates timely referral for targeted interventions.
- Personalized risk assessment improves management of extremely preterm infants.
Abstract:
Children born extremely preterm (<28 weeks' gestation) are at high risk of a range of adverse neurodevelopmental outcomes in later childhood compared with their peers born at term, including cognitive, motor, and behavioral difficulties. These difficulties can be associated with poorer academic achievement and health outcomes at school age. In this review, we discuss several predictors in the newborn period of early childhood neurodevelopmental outcomes including perinatal risk factors, neuroimaging findings and neurobehavioral assessments, along with social and environmental influences for children born extremely preterm. Given the complexity of predicting long-term outcomes in children born extremely preterm, we recommend multi-disciplinary teams in clinical practice to assist in determining an individual child's risk for adverse long-term outcomes and need for referral to targeted intervention, based upon their risk.
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