Related Experiment Video
Updated: Jul 16, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Utility of the 21-month neurodevelopmental outcome for predicting neurodevelopmental impairment at 36 months for
Stefani M Doucette1,2,3, Selphee Tang2,3,4, Heather Kehler2,3
1Division of Neonatology, Department of Pediatrics, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada.
Insights
Early neurodevelopmental assessments at 21 months in extremely preterm infants show low accuracy for predicting later impairment. This highlights the need for caution when interpreting these early outcomes for extremely preterm infants.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Neuroscience
Background:
- Extremely preterm infants (<29 weeks gestation) are at high risk for neurodevelopmental impairment.
- Early neurodevelopmental assessments are crucial for timely intervention.
- The predictive accuracy of early assessments in this vulnerable population requires further investigation.
Purpose of the Study:
- To evaluate the sensitivity and specificity of 21-month neurodevelopmental outcomes for predicting neurodevelopmental impairment at 36 months corrected age.
- To assess the predictive value of early neurodevelopmental assessments in preterm infants born before 29 weeks gestation.
Main Methods:
- Retrospective observational cohort study.
- Inclusion of preterm infants born <29 weeks gestation with available outcome data at 18-21 months and 36 months corrected age.
- Analysis of neurodevelopmental outcomes at two time points.
Main Results:
- The study included 713 preterm infants born <29 weeks gestation.
- Specificity of the 21-month assessment for predicting 36-month neurodevelopmental impairment was 66% (95% CI 62-71%).
- Positive predictive value was 61% (95% CI 56-66%).
Conclusions:
- Early neurodevelopmental outcomes at 18-21 months have low specificity and positive predictive value in preterm neonates born <29 weeks gestation.
- These findings suggest that early assessments alone may not reliably predict later neurodevelopmental impairment in this population.
- Caution is advised when using 21-month assessments to predict 36-month neurodevelopmental impairment in extremely preterm infants.
Objective:
To determine the sensitivity and specificity of the 21-month neurodevelopmental outcome for predicting the presence of neurodevelopmental impairment at 36 months corrected age in a population of preterm infants under 29 weeks gestation.
Study Design:
This is a retrospective observational cohort study. Preterm infants born under 29 weeks gestation who were followed up at both 18-21 months and 36 months corrected age with outcome data available were enrolled.
Results:
Overall, 713 preterm infants <29 weeks gestation and were included in the final analysis. The specificity of the 21-month assessment for predicting neurodevelopmental impairment at 36 months corrected age was 66% (95% confidence interval[CI] 62-71%) with a positive predictive value of 61% (95% CI 56-66%).
Conclusion:
In preterm neonates born <29 weeks gestation, the 18-21 months corrected neurodevelopmental outcome had low specificity and positive predictive value for predicting the presence of neurodevelopmental impairment at 36 months corrected age.
