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J Pediatr. 2010 Mar;156(3):366-71. doi: 10.1016/j.jpeds.2009.09.042. Epub 2009 Nov 1.

Neurobehavioral assessment predicts motor outcome in preterm infants.

Author information

  • 1Department of Pediatrics, Alpert Brown Medical School, Providence, RI, USA. bstephens@wihri.org

Abstract

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).

STUDY DESIGN:

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.

Copyright 2010 Mosby, Inc. All rights reserved.

PMID:
19880137
[PubMed - indexed for MEDLINE]
PMCID:
PMC3121326
Free PMC Article

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