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Prediction of developmental patterns through 40 months from 6- and 12-month neurologic examinations in very low birth
S R Wildin1, K Smith, A Anderson
1Department of Pediatrics (Child Development), University of Texas Medical Branch, Galveston 77555-0319, USA.
Insights
Neurologic exams in the first year can predict developmental trajectories in very low birth weight infants. Abnormal scores indicated cognitive decline in high-risk infants, while the 12-month exam predicted motor development changes.
Area of Science:
- Developmental Pediatrics
- Neonatology
- Neurodevelopmental Outcomes
Background:
- Very low birth weight (VLBW) infants face risks for neurodevelopmental challenges.
- Early identification of developmental trajectories is crucial for timely intervention.
- Predictive value of early neurologic assessments in VLBW infants requires further investigation.
Purpose of the Study:
- To determine if neurologic examinations at 6 and 12 months predict developmental patterns in VLBW infants and full-term controls up to 40 months.
- To assess the influence of medical risk and socioeconomic status on neurodevelopmental outcomes.
Main Methods:
- Longitudinal study involving VLBW infants and full-term controls.
- Neurologic examinations performed at 6 and 12 months of age.
- Standardized developmental assessments including Bayley Scales of Infant Development, Stanford-Binet, and McCarthy Motor Scale administered at various ages up to 40 months.
- VLBW infants categorized by socioeconomic status and medical risk.
Main Results:
- Abnormal neurologic scores at 6 and 12 months predicted greater cognitive development deceleration in high-risk VLBW infants.
- The 12-month neurologic examination was a significant predictor of motor development deceleration.
- Medical risk independently predicted alterations in the psychomotor development curve.
Conclusions:
- Neurologic examinations in infancy can offer valuable predictive information regarding neurodevelopmental trajectories in VLBW infants.
- These assessments, particularly at 12 months, may aid in identifying infants who could benefit from early-intervention programs.
- Integrating neurologic findings with risk factors like medical complications enhances prediction accuracy.
Abstract:
This study examines whether neurologic examinations at 6 and 12 months of age can predict developmental patterns in very low birth weight infants and fullterm controls through 40 months of age. We performed neurologic examinations at 6 and 12 months; the Bayley Scales of Infant Development at 6, 12, and 24 months; and the Stanford-Binet and the McCarthy Motor scale at 40 months. The very low birth weight infants were categorized on the basis of socioeconomic status and high or low risk for early medical complications. More abnormal neurologic scores predicted greater deceleration of cognitive development for high-risk infants only. The 12-month neurologic examination predicted the degree of deceleration in motor development. Medical risk was an independent predictor of curvature of the psychomotor development curve. We conclude that neurologic examinations during the 1st year of life might be used with other factors in decision concerning referrals to early-intervention programs.