Neurobehavioral assessment predicts motor outcome in preterm infants.
OBJECTIVE
To determine whether Neonatal Intensive Care Unit Network Neurobehavior Scales (NNNS) at 44 weeks predict motor outcome at 2 years in preterm infants from the Maternal Lifestyles Study (MLS).


METHODS
Data were collected on all preterm infants (<36 weeks) in the MLS who underwent an NNNS at 44 weeks (n = 395) and neurologic examination at 12 to 36 months or Bayley Psychomotor Development Index (PDI) at 24 months (n = 270). Logistic regression analyzed NNNS summary scores associated with cerebral palsy (CP) or PDI <70, while controlling for birth weight </=1250 g.


RESULTS
Eighteen of 395 infants (5%) had CP; 24 of 270 infants (9%) had PDI <70. CP was associated with low quality of movement (odds ratio [OR], 1.95; 95% CI, 1.24-3.06; P = .004) and high lethargy (OR, 1.67; 95% CI, 1.01-2.76; P = .045). The model contributed 19% of the variance in CP diagnosis at 12 to 36 months (R(2) = .19, P < .001). Low PDI was associated with low handling (OR, 1.83; 95% CI, 1.12-2.99; P = .017), low quality of movement (OR, 2.16; 95% CI, 1.38-3.38; P = .001), and hypotonia (OR, 1.63; 95% CI, 1.14-2.32; P = .007). The model contributed 26% of the variance in PDI <70 at 24 months (R(2) = 0.26, P < .001).


CONCLUSIONS
The neurobehavioral profile of under-arousal in 44-week-old preterm infants may predict poor motor outcome.
Stephens
Bonnie E
BE
Department of Pediatrics, Alpert Brown Medical School, Providence, RI, USA. bstephens@wihri.org
Liu
Jing
J
Lester
Barry
B
Lagasse
Linda
L
Shankaran
Seetha
S
Bada
Henrietta
H
Bauer
Charles
C
Das
Abhik
A
Higgins
Rosemary
R
D000293:Adolescent; D000328:Adult; D002547:Cerebral Palsy / Q000175:diagnosis*; D002675:Child, Preschool; D019970:Cocaine-Related Disorders; D002658:Developmental Disabilities / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications; D055815:Young Adult