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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurobehavior in very preterm infants with low medical risk and full-term infants
Roberta Pineda1,2,3,4,5, Lara Liszka6,7, Pido Tran6
1Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA. bobbi.pineda@chan.usc.edu.
Insights
Very preterm infants, even with low medical risk, show less optimal neurobehavior and more stress at term equivalent age compared to full-term infants. These findings highlight subtle developmental differences in high-risk newborns.
Area of Science:
- Neonatal Neuroscience
- Developmental Pediatrics
Background:
- Preterm birth can impact neurodevelopmental outcomes.
- Assessing neurobehavior at term equivalent age is crucial for identifying subtle differences.
Purpose of the Study:
- To compare neurobehavioral outcomes between very preterm infants with low medical risk and full-term infants at term equivalent age.
- To identify specific areas of neurobehavioral difference.
Main Methods:
- Standardized neurobehavioral assessments were performed on 136 very preterm infants (born ≤32 weeks gestation, low medical risk) and 50 full-term infants.
- Low medical risk was defined by specific criteria including ventilation duration and absence of major morbidities.
- The NICU Network Neurobehavioral Scale and Hammersmith Neonatal Neurological Examination were utilized.
Main Results:
- Very preterm infants exhibited significantly more sub-optimal reflexes and stress on the NICU Network Neurobehavioral Scale (p<0.001).
- Infants born prematurely also performed worse on the Hammersmith Neonatal Neurological Examination (p=0.005).
Conclusions:
- Very preterm infants with low medical risk demonstrate less optimal neurobehavior at term equivalent age compared to full-term infants.
- These findings suggest persistent neurodevelopmental impacts of prematurity, even in the absence of significant medical complications.
Objective:
To describe differences in neurobehavior among very preterm infants with low medical risk at term equivalent age and full-term infants.
Study Design:
One-hundred eighty-six (136 infants born ≤32 weeks gestation with low medical risk at term equivalent age and 50 full-term infants within 4 days of birth) had standardized neurobehavioral assessments. Low medical risk was defined by ventilation <10 days and absence of significant brain injury, necrotizing enterocolitis, patent ductus arteriosus, and retinopathy of prematurity.
Results:
Very preterm infants with low medical risk at term equivalent age demonstrated more sub-optimal reflexes (p < 0.001; ß = 1.53) and more stress (p < 0.001; ß = 0.08) on the NICU Network Neurobehavioral Scale compared to their full-term counterparts. Very preterm infants with low medical risk also performed worse on the Hammersmith Neonatal Neurological Examination (p = 0.005; ß = -3.4).
Conclusion:
Very preterm infants at term equivalent age continue to demonstrate less optimal neurobehavior compared to full-term infants.
