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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Predictors influencing neurodevelopment during the infancy of term infants
Yixia Zhang1, Bo Hu1, Zhipeng Jin2
1Child Health Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China.
Insights
Gestational age, birth weight, and maternal folic acid supplementation positively influence infant neurodevelopment. Conversely, infant overweight and NICU stay negatively impact development, highlighting key factors for monitoring term infants.
Area of Science:
- Pediatrics
- Neurodevelopmental Biology
Background:
- Neurodevelopmental outcomes in term infants are crucial for long-term health.
- Identifying influencing factors aids in early intervention and management strategies.
Purpose of the Study:
- To determine factors influencing the neurodevelopment of term infants aged under one year.
- To establish a basis for neurodevelopmental monitoring and management.
Main Methods:
- A cohort of 327 term infants (4-12 months) was assessed using the Developmental Behavior Assessment Scale.
- Univariate and multiple linear regression analyses were performed to identify influencing factors.
Main Results:
- Greater gestational age (GA) and birth weight (BW) predicted higher total development quotient (TDQ) scores.
- Infant overweight status was associated with lower TDQ and gross motor scores.
- Increased GA, maternal folic acid supplementation, and higher maternal education predicted better neurodevelopmental outcomes in specific domains.
- Neonatal intensive care unit (NICU) admission and gestational hypertension were linked to poorer outcomes.
Conclusions:
- GA, BW, BMI, NICU admission duration, maternal folic acid supplementation, gestational hypertension, and maternal education level significantly influence infant neurodevelopment.
- These factors provide targets for monitoring and intervention to support optimal neurodevelopment in term infants.
Objectives:
This study aimed to determine the influencing factors of neurodevelopment of term infants (37-41 6/7 weeks) aged <1 year to provide a basis for neurodevelopment monitoring and management of term infants.
Study Design:
A total of 327 term infants aged 4-12 months who visited the outpatient department of Child Health Care at the Children's Hospital Affiliated to Zhengzhou University from December 2023 to June 2024 were included. The Developmental Behavior Assessment Scale for Children aged 0-6 years was used to assess the neurodevelopment of infants who underwent routine physical examination. Univariate and multiple linear regression analyses of the influencing factors on neurodevelopment were conducted.
Results:
Greater gestational age (GA) and birth weight (BW) were independent predictors of a higher total development quotient (TDQ) score (t = 2.191 and 2.462, respectively; both p < 0.05). Overweight and a trend toward overweight in infants were predictors of a low TDQ score (t = -2.663, p = 0.008). The R 2 value was 0.135 (adjusted R 2 = 0.116) with a root mean square error (RMSE) of 7.138, showing that 13.5% of the TDQ score is explained by differences in GA, BW, and body mass index (BMI). Increased GA and maternal folic acid supplementation prior to pregnancy were independently associated with a higher gross motor score (t = 2.377 and -2.128, respectively; both p < 0.05). Conversely, infant overweight status or a trend toward overweight was associated with a lower gross motor score (t = -2.466, p = 0.014). Greater GA and older age were independent predictors of a higher fine motor score (t = 2.155 and 4.502, respectively; both p < 0.05). Longer days of neonatal intensive care unit (NICU) admission during the neonatal period were a predictor of a lower fine motor score (t = -3.528, p < 0.001). Greater GA was an independent predictor of a higher adaptability score (t = 3.245, p < 0.001). Older age was a predictor of a lower adaptability score (t = -4.113, p < 0.001). Maternal junior college or above was an independent predictor of a higher language score (t = 2.350, p = 0.019). Older age and gestational hypertension were predictors of a lower language score (t = -5.553 and -2.604, respectively; both p < 0.05). No factor was found to be an independent predictor of the social behavior score.
Conclusion:
GA, BW, BMI, days of NICU admission, prenatal folic acid supplementation of mothers, gestational hypertension, and maternal educational level were influencing factors in the neurodevelopment of infants aged 4-12 months.
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