Neurobehavioral Assessment Predicts Motor Outcome in Preterm Infants

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• 作者：Bonnie E. Stephens ; Jing Liu ; Barry Lester ; Linda Lagasse ; Seetha Shankaran ; Henrietta Bada ; Charles Bauer ; Abhik Das ; Rosemary Higgins
• 刊名：The Journal of Pediatrics
• 出版年：2010
• 出版时间：March 2010
• 年：2010
• 卷：156
• 期：3
• 页码：366-371
• 全文大小：130 K

文摘

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 (R² = .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 (R² = 0.26, P < .001).

Conclusions

The neurobehavioral profile of under-arousal in 44-week-old preterm infants may predict poor motor outcome.