Extreme prematurity is associated with adverse neurodevelopmental outcomes, which may be due to chronic physiologic instability. We correlated 28 day cumulative scores for neonatal acute physiology (SNAP) with 1 and 2 yr developmental outcomes in infants ≤ 30 weeks gestational age (GA). Daily SNAP scores were summed over the first 28 days in 96 infants (mean GA 27.3± 1.6 wks and birthweight 1085 ± 271g). The mental and psychomotor indices (MDI and PDI) of the Bayley Scales of Infant Development(II) were administered at 1 and 2 yrs of age; the Receptive-Expressive Emergent Language Scale (REEL) was administered at 2 yrs of age. Infants were ranked by 28 day SNAP scores and grouped by quartiles. Outcomes were compared using ANOVA. Higher 28 day SNAP scores were associated (p<0.05) with lower MDI (1 and 2 yrs), PDI (1 and 2 yrs), and increased incidence of combined neurodevelopmental morbidity (see table). REEL and 28 day SNAP scores were not correlated. Using stepwise regression analyses, 28 day SNAP and intracranial anomalies (ICA), but not GA, were predictors of 1 yr MDI and 1 and 2 yr PDI. For 2 yr MDI, only 28 day SNAP scores were a significant predictor. GA was not a significant cofactor in any analysis.

Table 1
Full size table