Neurobiologic Risk Score and Long-term Developmental Outcomes of Premature Infants, Birth Weight Less Than 1,250 Grams
PRACHA NUNTNARUMIT, M.D.*, HENRIETTA S. BADA, M.D.**, SHELDON B. KORONES, M.D.**, WENJIAN YANG,Ph.D.***
Affiliation : * Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand. ** Department of Pediatrics and Obstetrics and Gynecology, The University of Tennessee, Memphis, Tennessee, USA. *** Department of Mathematical Science, The University of Memphis, Tennessee, USA.
Objective : To determine whether neurobiologic risk score (NBRS) would continue to correlate with developmental outcomes.
Method : An observational cohort consisting of 258 surviving infants who returned to the follow-up clinic with a mean age 22 months' corrected age. Both univariate and multivariate analysis were performed to identify risk factors and to assess the predictive value of NBRS.
Results : Forty-eight to 53 per cent of these infants had growth parameters < 25'h percentile for age. Seventeen and 18 per cent respectively had mental developmental index (MDI) and psycho motor developmental index (PDI) on the Bayley Scales less than 70 and 14 per cent developed cerebral palsy (CP). NBRS demonstrated a significant correlation with the outcome (p<0.001). In infants with NBRS;::: 8, 48 per cent had MDI< 70 and 68 per cent, had PDI < 70. At a similar NBRS cut off, specificity and negative predictive value (NPV) were 86 and 96 per cent, respectively. Logistic regression indicated that birth weight and gestational age were the most significant independent variables for predicting poor outcomes.
Conclusion : Very preterm infants in the present study were at risk for abnormal develop mental outcomes. NBRS demonstrated a very high specificity and NPV and may be a useful index to identify those who need early intervention.
Keywords : Developmental Outcome, Preterm Infant, Neurobiologic Risk Score
