Evaluation of the ability of neurobiological, neurodevelopmental and socio-economic variables to predict cognitive outcome in premature infants

• Published in: Child : care, health & development Vol. 38; no. 5; pp. 683 - 689
• Main Authors: Wickremasinghe, A. C., Hartman, T. K., Voigt, R. G., Katusic, S. K., Weaver, A. L., Colby, C. E., Barbaresi, W. J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-09-2012
• Subjects: Adult; Age; Babies; Capute Scales; CAT/CLAMS; child development; Child, Preschool; Cognition Disorders - diagnosis; Cognitive ability; Developmental Disabilities - diagnosis; Economic Factors; Economic Status; Educational Status; Female; Haemorrhage; Health education; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - diagnosis; Intensive care; Male; Marital Status; Maternal Age; Mothers - psychology; Mothers - statistics & numerical data; Neonates; Neurobiology; Neurologic Examination - standards; neurological examination; Pediatrics; Premature; Premature babies; Premature birth; Premature Infants; Prognosis; Psychiatric Status Rating Scales - standards; Risk Assessment - methods; Risk Assessment - standards; Risk Factors; socio-economic factors; Socioeconomic Factors; Socioeconomic Status; Young Children
• ISSN: 0305-1862; 1365-2214
• DOI: 10.1111/j.1365-2214.2011.01281.x

Background  When developed in the 1990s, the Neurobiologic Risk Score (NBRS) and Neurodevelopmental Risk Exam (NRE) correlated well with developmental outcomes in premature infants. Given recent advances in neonatology, we assessed their present ability to predict cognitive outcome, alone and combined with socio‐economic factors.
Methods  One hundred and twenty‐nine neonates <32 weeks gestational age were assessed at 6, 12 and/or 24 months corrected age with the Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS). Indices of socio‐economic status included maternal education and marital status.
Results  At 24 months corrected age (n= 67), the NBRS (r=−0.5), maternal education (r= 0.46) and marital status (r= 0.37) correlated with the CAT/CLAMS. These correlations increased when NBRS and maternal education were combined (r= 0.63) and when specific NBRS components (intraventricular haemorrhage, periventricular leukomalacia, seizures) and maternal education were combined (r= 0.66).
Conclusions  In the contemporary neonatal intensive care unit, measures used to predict cognitive outcome should incorporate both neurobiological risk factors and socio‐economic variables.