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Updated: May 20, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental outcomes at age 3 years of preterm infants born at 22-31 weeks' gestation
Yumi Kono1, Satoshi Kusuda2,3, Toshihiko Nishida4
1Jichi Medical University, Shimotsuke, Tochigi, Japan. ykono@jichi.ac.jp.
Insights
Neurodevelopmental outcomes improve with gestational age (GA) in very preterm infants. Over half of infants born at 22-23 weeks survived without neurodevelopmental impairment.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Clinical Epidemiology
Background:
- Very preterm infants face significant risks of neurodevelopmental impairment (NDI).
- Gestational age (GA) is a critical factor influencing outcomes for these vulnerable infants.
- High-quality follow-up data is essential for accurate outcome assessment.
Purpose of the Study:
- To evaluate neurodevelopmental outcomes in very preterm infants based on gestational age.
- To assess the rate of survival without moderate or severe neurodevelopmental impairment (NDI).
- To analyze the relationship between GA and NDI in a large cohort.
Main Methods:
- Secondary analysis of the Improvement of NICU practices and Team Approach Cluster randomized controlled Trial (INTACT).
- Included infants born before 32 weeks' gestation (2012-2014).
- Assessed neurodevelopmental outcomes at three years of age with a high follow-up rate.
Main Results:
- NICU survival rate was 96.5% across GAs from 22-31 weeks.
- At three years, 89.5% of survivors were assessed; 303 had moderate NDI and 183 had severe NDI.
- Proportions of infants surviving without NDI increased with GA, from 45.2% at 22 weeks to 88.1% at 31 weeks.
Conclusions:
- Survival without NDI significantly varies by gestational age.
- More than half (55.0%) of infants born at 22-23 weeks survived without neurodevelopmental sequelae by age three.
- Gestational age is a key determinant of neurodevelopmental outcomes in very preterm infants.
Objective:
To evaluate neurodevelopmental outcomes of very preterm infants by gestational age (GA) using high follow-up rate data.
Study Design:
This secondary analysis included infants born before 32 weeks' gestation in 2012-2014 from the Improvement of NICU practices and Team Approach Cluster randomized controlled Trial (INTACT). The primary outcome was survival without moderate or severe neurodevelopmental impairment (NDI).
Results:
Among 2722 infants, NICU survival rate was 96.5%, ranging 72.1-99.6% at 22-31 weeks. At age three years, 2336 (89.5% of 2610 survivors) were completely assessed; 303 had moderate NDI and 183 had severe NDI. Of these, the proportions of infants surviving without NDI increased with GA; 45.2% at 22 weeks, 57.5% at 23 weeks, 88.1% at 31 weeks.
Conclusion:
Although survival without NDI varied by GA, more than half (55.0%, 83/151) of infants born at 22-23 weeks who survived to age three years were without neurodevelopmental sequelae.
