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