Related Experiment Video
Updated: Sep 17, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Count of Neonatal Morbidities Predicts Outcomes at Age 10 and 15 Years in Infants Born Extremely Preterm
Ruben Vaidya1, Joe X Yi2, T Michael O'Shea2
1Department of Pediatrics, University of Massachusetts Chan Medical School - Baystate, Springfield, MA.
Insights
A simple count of neonatal morbidities like bronchopulmonary dysplasia (BPD) and sepsis in extremely preterm infants predicts long-term neurocognitive impairment, health issues, and reduced quality of life (QOL) at ages 10 and 15.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Longitudinal Cohort Studies
Background:
- Extremely preterm infants face significant risks for neonatal morbidities.
- These morbidities may have lasting impacts on child development and health outcomes.
- Predictive markers for long-term outcomes in this vulnerable population are crucial.
Purpose of the Study:
- To determine if a count of common neonatal morbidities predicts long-term neurocognitive, medical, behavioral, and quality of life (QOL) outcomes.
- To assess these predictions at ages 10 and 15 years in children born extremely preterm.
- To investigate the relationship between the number of neonatal morbidities and later-life health and development.
Main Methods:
- Prospective, longitudinal study of extremely low gestational age newborns (ELGANs).
- Participants categorized by the number of neonatal morbidities (0, 1, 2, or ≥3): bronchopulmonary dysplasia (BPD), severe brain injury (SBI), severe retinopathy of prematurity (ROP), surgical necrotizing enterocolitis (NEC), and sepsis.
- Neurocognitive, general medical, behavioral health, and QOL assessed at ages 10 and 15 years.
Main Results:
- A linear relationship was observed between the number of neonatal morbidities and moderate-to-severe neurocognitive impairment at ages 10 and 15.
- Increased morbidities correlated with higher probabilities of motor impairment, legal blindness, severe hearing loss, and multiple health disorders at age 10.
- A greater number of neonatal morbidities was associated with poor quality of life (QOL) at age 10.
Conclusions:
- A simple count of common neonatal morbidities is a significant predictor of long-term outcomes in extremely preterm survivors.
- The number of neonatal morbidities linearly predicts neurocognitive impairment, general health status, and QOL.
- These findings highlight the cumulative impact of early-life morbidities on long-term child development and well-being.
Objective:
To assess whether a simple count of 5 common neonatal morbidities, including bronchopulmonary dysplasia (BPD), ultrasound-identified severe brain injury (SBI), severe retinopathy of prematurity (ROP), surgical necrotizing enterocolitis (NEC), and sepsis predict long-term neurocognitive impairment, general medical health, behavioral health, or quality of life (QOL) at age 10 and 15 years in children born extremely preterm.
Study Design:
Participants from the multicenter, prospective, longitudinal study extremely low gestational age newborns (ELGANs) were followed at ages 10 and 15 years and were categorized into groups with 0, 1, 2, or ≥3 neonatal morbidities (BPD, SBI, ROP, NEC, or sepsis). Long-term neurocognitive outcomes were assessed using latent profiles generated from standardized tests of intelligence and executive function. General medical health, behavioral health, and QOL were assessed using standardized assessments.
Results:
Of 1198 participants who survived to age 10 889 (74.2%) and 694 (57.9%) were evaluated at age 10 and 15 years, respectively. The number of neonatal morbidities was linearly related to the probability of moderate-to-severe neurocognitive impairment at age 10 and 15 years, and the probability of motor impairment, legal blindness, severe hearing loss, number of health disorders, ≥2 health disorders, and poor QOL at age 10 years.
Conclusions:
Among newborns born extremely preterm who survive long-term, a simple count of neonatal morbidities (including BPD, SBI, ROP, NEC, or sepsis) is linearly related to neurocognitive impairment, poor general health, and QOL.
