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Updated: Oct 10, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Screening for Neurodevelopmental Delay for Preterm Very Low Birth Weight Infants at Tertiary Care Center in Saudi
Mohammed Y Al-Hindi1,2,3, Bashaer H Almahdi1, Dinah A Alasmari1
1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.
Insights
A study found that 42.6% of preterm infants screened using the Arabic Ages and Stages Questionnaire (ASQ3-A) showed neurodevelopmental delays. Perinatal events and periventricular leukomalacia were key predictors, highlighting the need for early screening in resource-limited settings.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Public Health
Background:
- Preterm infants face higher risks of mortality and long-term neurodevelopmental impairments.
- Resource-limited settings lack definitive tools for assessing these risks.
- An Arabic screening tool is crucial for the Arabic-speaking population.
Purpose of the Study:
- To assess the early detection rate of neurodevelopmental delay (NDD) in preterm, very low birth weight (VLBW) infants using the Arabic Ages and Stages Questionnaire (ASQ3-A).
- To identify predictors of NDD in this vulnerable population.
Main Methods:
- A cross-sectional study involving 61 preterm infants (born <32 weeks gestation or VLBW <1500g) admitted to neonatal ICU.
- Developmental assessment conducted at 18-24 months corrected gestational age (CGA) using ASQ3-A.
- NDD defined as delay in communication, gross motor, fine motor, problem-solving, or personal-social skills.
Main Results:
- 42.6% (26/61) of infants exhibited at least one NDD.
- Highest prevalence of delay observed in personal-social skills (23%) and problem-solving (19.7%).
- Perinatal events and periventricular leukomalacia (PVL) were significant independent predictors of NDD.
Conclusions:
- The ASQ3-A identified significant NDD in 42.6% of preterm VLBW infants in Saudi Arabia.
- Early screening with ASQ3-A is recommended, particularly in resource-limited settings, to facilitate early intervention.
- Further multicenter studies with definitive diagnostic tools are needed to establish national benchmarks for long-term neurodevelopmental outcomes.
Abstract:
Background Preterm infants are more susceptible to death, short-term complications, and long-term complications such as neurodevelopmental impairments. However, definitive assessment tools are not available in a resource-limited setting. Hence a screening tool is needed the Arabic-speaking population. Method Infants born at a gestational age of <32 weeks or a very low birth weight (VLBW) of less than 1500 g were recruited into a cross-sectional study. We identified infants (n = 61) admitted to the neonatal ICU at King Abdulaziz Medical City and reached 18 up to 24 months of corrected gestational age (CGA). The developmental assessment was done at 18, 20, 22, and 24 CGAs using the Ages and Stages Questionnaire third edition - Arabic version (ASQ3-A). The primary outcomes are early detection rate of neurodevelopmental delay (NDD), defined as a delay in one or more of the following: communication, gross motor, fine motor, problem-solving, and personal-social skills as per ASQ3-A. Results Sixty-one out of 92 eligible infants (36 excluded) completed the sufficient assessment. Twenty-six infants (42.6%) had at least one NDD in one of the following domains: communication skills: (11.5%), gross motor: (11.5%), fine motor: (19.7%), problem-solving skills: twelve infants (19.7%), and personal-social skills: twenty infants (23%). Perinatal events and periventricular leukomalacia (PVL) were significant independent predictors for the NDD. Conclusion This single-center study in Saudi Arabia screened preterm, VLBW infants based on ASQ3-A, twenty infants (42.6%) had an abnormal NDD at a corrected age of 18-24 months. Perinatal events and PVL were independent predictors of NDD. We recommend that all preterm VLBW infants in Saudi Arabia be evaluated by a neurodevelopmental screening tool, ASQ3-A, especially in resource-limited settings to start early intervention. Also, more extensive multicenter studies are to be carried out with definitive diagnostic tools to have a national benchmark for the long-term neurodevelopmental impairment.
