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Prediction of growth and development in intensive care nursery graduates at 12 months of age
Insights
Neonatal behavioral assessments weakly predict neurodevelopmental outcomes in NICU graduates at 12 months. However, functional status and behavioral evaluations are crucial for assessing short-term outcomes in these infants.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Longitudinal Studies
Background:
- Perinatal events are linked to outcomes for neonatal intensive care unit (NICU) graduates.
- Few studies have longitudinally evaluated cumulative outcome prediction in NICU graduates.
- Understanding predictors of neurodevelopmental and growth outcomes is crucial for NICU graduates.
Purpose of the Study:
- To evaluate the cumulative longitudinal prediction of 12-month outcome in NICU graduates.
- To identify variables that predict growth, neurologic, and developmental status at 12 months.
Main Methods:
- Followed 65 term and 139 premature NICU graduates to 12 months chronologic age.
- Utilized maternal/neonatal medical factors, prior growth, and neonatal behavior (Brazelton Scale/modified version) for prediction.
- Assessed neurologic status and developmental outcomes using Bayley Scales (Mental Developmental Index and Psychomotor Developmental Index).
Main Results:
- Neurologic status was normal in 71.9% of infants.
- Predictions of 12-month neurodevelopmental status were weak, primarily derived from neonatal behavioral variables (endurance for neurologic, motor cluster for development).
- Prediction of 12-month growth was high, based on prior growth parameters.
Conclusions:
- Neonatal behavioral evaluations are important for predicting neurodevelopmental outcomes in NICU graduates.
- Functional status and behavioral assessments should complement traditional perinatal factors when evaluating short-term outcomes.
- Further research into predictive models for NICU graduate outcomes is warranted.
Abstract:
Although many perinatal events have been linked with the outcome status of neonatal intensive care unit (NICU) graduates, few studies have evaluated the cumulative longitudinal prediction of outcome. This study followed up 65 term and 139 premature NICU graduates to 12 months' chronologic age. Variables that were utilized in predicting 12-month growth and the neurologic and developmental outcome were maternal and neonatal medical factors, prior growth measurements, and neonatal behavior, which was measured with the Brazelton Scale for term infants and with a modified version for premature infants. The neurologic status was normal in 141 (71.9%) of 204 infants. The average Bayley Scale Mental Developmental Index was 112.7, and the average Psychomotor Developmental Index was 97.5, which was corrected for early gestation. Predictions of 12-month neurologic and developmental status were weak and had been derived only by variables from the neonatal behavioral examination; endurance predicted neurologic status and the motor cluster predicted cognitive and motor development. The prediction of growth at 12 months was high and was derived from prior growth parameters. Thus, although predictions of neurodevelopmental status at 12 months' chronologic age were low, the variables that aided in predicting were from the neonatal behavioral evaluation. This finding provides support for recommending that the functional status of the NICU graduate as well as the more traditional list of perinatal problems be considered when contemplating the infants' short-term outcome.