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Updated: Jun 9, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal Morbidities, Neurodevelopmental Impairments, and Positive Health among Children Surviving Birth before
J Wells Logan1, Xiaodan Tang2, Rachel G Greenberg3
1Department of Pediatrics, University of Florida College of Medicine - Jacksonville, Jacksonville, FL.
Insights
Children born very preterm with bronchopulmonary dysplasia, intraventricular hemorrhage, or cerebral palsy had lower positive health scores reported by parents in early childhood. However, adolescents’ own reports showed no association with these early-life morbidities or impairments.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Pediatric Health Outcomes
Background:
- Children born very preterm (< 32 weeks gestation) face risks for neonatal morbidities and neurodevelopmental impairments.
- Assessing long-term positive health outcomes in this population is crucial for understanding developmental trajectories.
- Previous research has focused on deficits, necessitating an evaluation of positive health indicators.
Purpose of the Study:
- To evaluate positive health outcomes in children born very preterm.
- To determine if common neonatal morbidities and neurodevelopmental impairments impact later positive health.
- To compare parent-proxy and self-reported outcomes across different age groups.
Main Methods:
- Secondary analysis of prospectively acquired data from three multicenter cohorts of very preterm infants.
- Examined associations between bronchopulmonary dysplasia, necrotizing enterocolitis, intraventricular hemorrhage, developmental delays, and cerebral palsy.
- Utilized Patient-Reported Outcomes Measurement Information System (PROMIS) scales for positive health, assessed in early childhood and adolescence.
Main Results:
- Parent-proxy reports in early childhood showed lower positive health scores associated with bronchopulmonary dysplasia, intraventricular hemorrhage, and cerebral palsy.
- No significant associations were found between these neonatal morbidities/impairments and positive health scores in adolescence when reported by the children themselves.
- Developmental delays and necrotizing enterocolitis were not significantly associated with positive health scores in either assessment period.
Conclusions:
- Parental perceptions of positive health in early childhood are lower for very preterm children with specific neonatal morbidities or impairments.
- Adolescents’ self-reported positive health outcomes are not negatively influenced by neonatal morbidities or preschool neurodevelopmental impairments.
- Findings suggest a potential divergence in outcome reporting between parents and adolescents, highlighting the importance of self-report in later childhood and adolescence.
Objectives:
To evaluate positive health outcomes among children born at < 32 weeks of gestation and to determine whether children with three common neonatal morbidities and 2 neurodevelopmental impairments would have similar positive health outcomes to children and adolescents without these exposures and impairments.
Study Design:
In this secondary analysis of prospectively acquired data derived from 3 multicenter cohorts of children born very preterm (the Extremely Low Gestational Age Newborn cohort [birth years 2001 to 2004], the Neurobehavior And Outcomes in Very Preterm Infants cohort [birth years 2014 to 2016], and the Developmental Impact of Neurobehavior And Outcomes in Very Preterm Infants Exposures cohort [birth years 2010 to 2020]), we examined associations between the 3 common neonatal morbidities (bronchopulmonary dysplasia, necrotizing enterocolitis, and intraventricular hemorrhage, diagnosed before hospital discharge), 2 neurodevelopmental impairments (developmental delays and cerebral palsy, diagnosed at preschool age follow-up), and perceptions of physical, mental, and social well-being (in either early childhood or adolescence), using the Patient-Reported Outcomes Measurement Information System scales for positive health.
Results:
After adjusting for confounders, bronchopulmonary dysplasia, intraventricular hemorrhage, and cerebral palsy were associated with lower positive health scores, reported by parent-proxy during early childhood. None of the exposures or impairments were associated with lower positive health scores at adolescence, reported by the children themselves.
Conclusion:
Parents of children born very preterm with bronchopulmonary dysplasia, intraventricular hemorrhage, or cerebral palsy rated their children's positive health lower than did parents of children without these morbidities. However, adolescents' own reports of positive health outcomes were not associated with either neonatal pre-discharge morbidities or preschool neurodevelopmental impairments.
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