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Updated: Jul 10, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopment and physical measurements in infants with birthweight of 500 grams or less
Ryo Itoshima1,2,3, Arata Oda1,2, Ryo Ogawa1,2
1Division of Neonatology, Nagano Children's Hospital, Azumino, Japan.
Insights
Neurodevelopmental impairment (NDI) in extremely low birth weight infants (≤500g) is linked to smaller head circumference at birth and reduced height at 18 months and 3 years. These growth parameters may predict long-term neurodevelopmental outcomes.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Pediatric Neurology
Background:
- Limited research exists on the neurodevelopmental prognosis of infants born weighing ≤500g concerning their physical growth.
- Understanding growth patterns is crucial for predicting neurodevelopmental outcomes in this vulnerable population.
Purpose of the Study:
- To investigate the association between neurodevelopmental impairment (NDI) and physical growth z-scores in infants born weighing ≤500g.
- To identify early growth indicators that may predict later neurodevelopmental status.
Main Methods:
- A retrospective cohort study was conducted in a level IV neonatal intensive care unit, including infants born weighing ≤500g between 2010 and 2019.
- Z-scores for weight, length/height, and head circumference were analyzed at multiple time points (birth, due date/discharge, 6, 18 months, 3 years).
- NDI was defined by developmental quotient ≤70, cerebral palsy, visual, or hearing impairment at 3 years.
Main Results:
- The incidence of NDI at 3 years was 54.5% among the eligible infants.
- Infants with NDI showed significantly smaller z-scores for head circumference at birth compared to those without NDI.
- Reduced height z-scores at 18 months corrected age and 3 years were also significantly associated with NDI.
Conclusions:
- NDI in infants born weighing ≤500g is associated with smaller head circumference at birth.
- Impaired linear growth, particularly height at 18 months and 3 years corrected age, is linked to NDI in this cohort.
- These findings highlight the importance of monitoring growth parameters for predicting neurodevelopmental outcomes in extremely low birth weight infants.
Background:
In infants born weighing ≤500 g, little has been studied about the association between neurodevelopmental prognosis and growth. This study aimed to evaluate the association between neurodevelopmental impairment (NDI) and z-scores of physical measurements in infants born weighing ≤500 g.
Methods:
A single-center, retrospective cohort study in a level IV neonatal intensive care unit in Japan. Infants born weighing ≤500 g between 2010 and 2019 were eligible. Z-scores in weight, length/height, and head circumference at birth, due date (or discharge), 6 and 18 months of corrected age, and 3 years of age were compared between infants with and without NDI at 3 years of age. Three infants with severe intraventricular hemorrhage or periventricular leukomalacia were excluded from the comparison analyses. NDI was defined as having a developmental quotient of ≤70, cerebral palsy, visual impairment, or hearing impairment.
Results:
Of 22 eligible infants, the incidence of NDI at 3 years of age was 54.5%. The z-score was significantly smaller in the NDI group (n = 10) than that in the non-NDI group (n = 9) in head circumference at birth (median, -1.94 vs. -0.75; Z = 0.54; p = 0.020), and in height at 18 months of corrected age (median, -2.84 vs. -1.79; Z = 0.58; p = 0.013) and 3 years of age (median, -2.02 vs. -1.21; Z = 0.47; p = 0.046).
Conclusions:
NDI at 3 years of age was associated with a small head circumference z-score at birth, height at 18 months of corrected age, and height at 3 years of age in infants born weighing ≤500 g.
