Usefulness of an early neurofunctional assessment in predicting neurodevelopmental outcome in very low birthweight infants.
OBJECTIVE
To evaluate whether early neurofunctional assessment may be useful in predicting neurodevelopmental outcome in children of very low birth weight (VLBW).


METHODS
Observational longitudinal study.


METHODS
Northern Italy.


METHODS
A total of 250 VLBW children (129 boys, 121 girls) born consecutively 1996-1999.


METHODS
Neurodevelopment at 36 months of chronological age, classified in accordance with the classification of Tardieu and the International classification of functioning.


RESULTS
Of the infants exhibiting normal neurodevelopment (n = 183) or major dysfunction (n = 17) at 3 months of corrected age, 72% and 94% respectively did not change their score during the study. Minor dysfunctions at 3 months of corrected age were transient in 17 (34%) children. After adjustment for neonatal variables, neurodevelopment at 3 months of corrected age remained predictive of dysfunction at 36 months (odds ratio = 4.33, 95% confidence interval 2.05 to 9.12). If the results for the normal and minor dysfunction groups were pooled, the predictive qualities of the 3 month neurofunctional assessment were: sensitivity 0.5, specificity 0.99, positive predictive value 0.94, negative predictive value 0.93.


CONCLUSIONS
Early neurofunctional evaluation may be useful in predicting later neurodevelopmental outcome in VLBW children.
NICU, Department of Neonatology, L Mangiagalli Clinic, Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, University of Milan,Via Commenda 12, 20122 Milano, Italy. o.picciolini@icp.mi.it
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Giannì
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Fumagalli
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Mosca
D000375:Aging / Q000502:physiology / Q000523:psychology; D000886:Anthropometry; D002547:Cerebral Palsy / Q000175:diagnosis; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology; D019102:Infant, Very Low Birth Weight / Q000523:psychology*; D008297:Male; D009460:Neurologic Examination / Q000379:methods; D011379:Prognosis; D011597:Psychomotor Performance