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Relations between infant neurobehavioral performance and cognitive outcome in very low birth weight preterm infants
I F Wallace1, S A Rose, C M McCarton
1Department of Otolaryngology, Rose F. Kennedy Center, Albert Einstein College of Medicine, Bronx, New York, 10461, USA.
Insights
Neonatal neurobehavioral assessments of visual following and auditory orienting in very low birth weight infants predict later cognitive development. These early indicators offer valuable insights into initial developmental capacities.
Area of Science:
- Neonatal neurobehavioral assessment
- Developmental psychology
- Pediatric neurology
Background:
- Assessing neurobehavioral performance in preterm infants is crucial for understanding developmental trajectories.
- Very low birth weight (VLBW) infants (< 1500 g) face heightened risks for cognitive impairments.
- Early identification of predictive markers can inform timely interventions.
Purpose of the Study:
- To examine the predictive utility of neonatal neurobehavioral performance on later cognitive outcomes in VLBW infants.
- To investigate the relationship between specific neurobehavioral composites and cognitive scores up to 6 years of age.
- To determine if early visual following and auditory orienting predict cognitive function in later childhood.
Main Methods:
- Longitudinal study of 144 VLBW infants followed until 6 years of age.
- Utilized the Einstein Neonatal Neurobehavioral Assessment Scale to derive visual-following, auditory-orienting, and active motility composites.
- Cognitive development assessed using the Mental Developmental Index (MDI) and IQ scores at various ages.
Main Results:
- Visual-following and auditory-orienting composites showed modest correlations with MDI and IQ scores across multiple ages.
- Deviant performance in neonatal visual following and auditory orienting was associated with significantly lower cognitive scores at 1 and 6 years.
- Infants with deviant performance in these areas were more likely to have subaverage IQ (< 85) at 6 years.
- These findings were independent of neonatal health status and motor scores, and excluded children with severe sensory impairments.
Conclusions:
- Neonatal visual following and auditory orienting are significant predictors of cognitive development in VLBW infants.
- These early neurobehavioral measures provide a valuable index of initial developmental capacities.
- The findings support the use of neonatal neurobehavioral assessments for early identification of children at risk for cognitive deficits.
Abstract:
The predictive utility of three aspects of neonatal neurobehavioral performance was examined in 144 very low birth weight (< 1500 g) preterms who were followed until 6 years of age. Visual-following and auditory-orienting composites derived from the Einstein Neonatal Neurobehavioral Assessment Scale were modestly related to the Mental Developmental Index (MDI) and IQ scores at several ages, whereas the active motility composite was only related to MDI scores at 1 year of age (corrected). Infants who showed deviant performance on both visual following and auditory orienting composites had significantly lower cognitive test scores at 1 and 6 years of age and were more likely to be classified as subaverage at 6 years of age (IQ < 85). Group differences were independent of both neonatal health status and motor scores and were not due to the performance of children with severe sensory impairments. These findings suggest that visual following and auditory orienting measured in the neonatal period can offer a useful way of indexing initial capacities.