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Neurobehavioral Assessment Predicts Differential Outcome Between VLBW and ELBW Preterm Infants

Abstract

OBJECTIVE:

To evaluate the impact of birth weight on development of very low birth weight (VLBW) infants using the Neurobehavioral Assessment of the Preterm Infant (NAPI) before hospital discharge, and to show the relation to follow-up outcomes at 12, 18 and 30 months of age.

STUDY DESIGN:

In total, 113 preterm infants were assessed with the NAPI at 36 weeks postmenstrual age. Later, neurodevelopment was examined using the Bayley Infant Neurodevelopmental Screener (BINS) at 12 months and the Bayley Scales of Infant Development, at 18 and 30 months. The cohort was divided into two groups, based on birth weight, extremely low birth weight (ELBW) (<1000 g) and VLBW (1000 to 1500 g).

RESULTS:

ELBW infants showed significantly lower NAPI scores compared with VLBW infants at 36 weeks. The predischarge NAPI scores correlated with the 12, 18 and 30 months scores when the ELBW infants continue to have lower performance than the VLBW infants. In all, 14 infants developed cerebral palsy. These infants had significantly lower NAPI, BINS and Bayley scores compared with all other preterm infants.

CONCLUSION:

NAPI before discharge provides clinically meaningful information related to later neurodevelopmental outcome.

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References

  1. Wilson-Costello D, Friedman H, Minch N, et al. Improved survival rates with increased neurodevelopmental disability for extremely low birth weight infants in the 1990s. Pediatrics 2005;115:997–1003.

    Article  Google Scholar 

  2. Vohr BR, Wright LL, Dusick AM, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network 1993 to 1994. Pediatrics 2000;105 (6):1216–1226.

    Article  CAS  Google Scholar 

  3. Vohr BR, Wright LL, Dusick AM, et al. Center differences and outcomes of extremely low birth weight infants. Pediatrics 2004;113:781–789.

    Article  Google Scholar 

  4. Lemons JA, Bauer CR, Oh W, et al. Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 through December 1996. Pediatrics 2001;107:1–8.

    Article  Google Scholar 

  5. Jarvis S, Glinianaia SV, Torrioli M, et al. Cerebral Palsy and intrauterine growth in single births: European collaborative study. Lancet 2003;362:1106–1111.

    Article  Google Scholar 

  6. Wood NS, Marlow N, Costeloe K, et al. Neurologic and developmental disability after extremely preterm birth. NEJM 2000;343:378–384.

    Article  CAS  Google Scholar 

  7. Saigal S, Hoult LA, Streiner DL, Stoskopf BL, Rosenbaum PL . School difficulties at adolescence in a regional cohort of children who were extremely low birth weight. Pediatrics 2000;105 (2):325–331.

    Article  CAS  Google Scholar 

  8. Grunau RE, Whitfield MF, Davis C . Patterns of learning disabilities in children with extremely low birth weight and broadly average intelligence. J Dev Behav Pediatr 2002;156:615–620.

    Google Scholar 

  9. Marlow N, Wolke D, Bracewell MA, Samara M . Neurologic and developmental disability at six years of age after extremely preterm birth. NEJM 2005;352:9–19.

    Article  CAS  Google Scholar 

  10. Korner AF, Brown JV, Thom VA, Constantinou JC . Neurobehavioral Assessment of the Preterm Infant Revised. 2nd ed. Van Nuys: Child Development Media, Inc; 2000.

    Google Scholar 

  11. Korner AF, Kraemer HC, Reade EP, et al. A methodological approach to developing an assessment procedure for testing the neurobehavioral maturity of preterm infants. Child Dev 1987;58:1478–1487.

    Article  CAS  Google Scholar 

  12. Korner AF, Brown Jr BW, Reade EP, et al. Stable individual differences in developmentally changing preterm infants: A replicated study. Child Dev 1989;60:502–513.

    Article  CAS  Google Scholar 

  13. Brown JV, Bakeman R, Coles CD, Sexson WR, Demi AS . Maternal drug use during pregnancy: Are preterm and full-term infants affected differently? Dev Psychol 1998;34 (3):540–554.

    Article  CAS  Google Scholar 

  14. Senn T, Espy KA . Effects of neurobehavioral assessment on feeding and weight gain in preterm neonates. J Dev Behav Pediatr 2003;24 (2):85–88.

    Article  Google Scholar 

  15. Ariagno RL, Thoman EB, Boeddiker MA, et al. Developmental care does not alter sleep and development of premature infants. Pediatrics 1997;100 (6):E9.

    Article  CAS  Google Scholar 

  16. Constantinou JC, Korner AK . Neurobehavioral Assessment of the Preterm Infant as an instrument to enhance parental awareness. Children's Health Care 1993;22 (1):39–46.

    Article  Google Scholar 

  17. Aylward GP, Bayley Infant Neurodevelopmental Screener. Psychological Corporation. San Antonio: Harcourt, Brace & Co; 1995.

    Google Scholar 

  18. Bayley N . Bayley Scales of Infant Development. 2nd ed. San Antonio: The Psychological Corporation; 1993.

    Google Scholar 

  19. Amiel-Tison C, Grenier A . Neurologic Evaluation of the Newborn and the Infant. New York: Masson Publication; 1983.

    Google Scholar 

  20. Korner AK, Stevenson DK, Forrest T, Constantinou JC, Dimiceli S, Brown BW . Preterm medical complications differentially affect neurobehavioral functions: results from a new Neonatal Medical Index. Inf Behav Dev 1994;17:37–43.

    Article  Google Scholar 

  21. Peterson BS, Anderson AW, Ehrenkranz R, et al. Regional brain volumes and their later neurodevelopmental correlates in term and preterm infants. Pediatrics 2003;111:939–948.

    Article  Google Scholar 

  22. Arzoumanian Y, Mirmiran M, Barnes PD, et al. Diffusion tensor brain imaging findings at term equivalent age may predict neurologic abnormalities in low birth weight preterm infants. Am J Neuroradiol 2003;24:1646–1653.

    CAS  PubMed  Google Scholar 

  23. Mirmiran M, Barnes PD, Keller K, et al. Neonatal brain magnetic resonance imaging before discharge is better than serial cranial ultrasound in predicting cerebral palsy in very low birth weight preterm infants. Pediatrics 2004;114:992–998.

    Article  Google Scholar 

  24. Latal-Hajnal B, von Siebenthal K, Kovari H, Bucher HU, Largo RH . Postnatal growth in VLBW infants: significant association with neurodevelopmental outcome. J Pediatr 2003;143:163–170.

    Article  Google Scholar 

  25. Woodward LJ, Mogridge N, Wells SW, Inder TE . Can neurobehavioral examination predict the presence of cerebral injury in the very low birth weight infant. Dev Behav 2004;25 (5):326–332.

    Article  Google Scholar 

  26. Maas YGH, Mirmiran M, Hart AAM, et al. Predictive value of neonatal neurological tests for developmental outcome of preterm infants. J Pediatr 2000;137:100–106.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported in part by a Grant from the David and Lucile Packard Foundation, Grant 5 M01 RR000070 from the National Institutes of Health awarded to the General Clinical Research Center, NIH/NINDS Grant R2INS 40374. The Mary L Johnson Research Fund, Innovations in Patient Care, and Lucile Packard Foundation for Children's Health.

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Constantinou, J., Adamson-Macedo, E., Mirmiran, M. et al. Neurobehavioral Assessment Predicts Differential Outcome Between VLBW and ELBW Preterm Infants. J Perinatol 25, 788–793 (2005). https://doi.org/10.1038/sj.jp.7211403

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