ORIGINAL ARTICLE

Usefulness of an early neurofunctional assessment in predicting neurodevelopmental outcome in very low birthweight infants

O Picciolini¹, M L Giannì², C Vegni¹, M Fumagalli¹ and F Mosca¹

¹ NICU, Department of Neonatology, L Mangiagalli Clinic, Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, Milan, Italy
² University of Milan, Institute of Pediatrics and Neonatology, Milan

Correspondence to:
Correspondence to:
Dr Picciolini
NICU, Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, University of Milan,Via Commenda 12, 20122 Milano, Italy; o.picciolini{at}icp.mi.it

Objective: To evaluate whether early neurofunctional assessment may be useful in predicting neurodevelopmental outcome in children of very low birth weight (VLBW).

Design: Observational longitudinal study.

Settings: Northern Italy.

Patients: A total of 250 VLBW children (129 boys, 121 girls) born consecutively 1996–1999.

Main outcome measures: Neurodevelopment at 36 months of chronological age, classified in accordance with the classification of Tardieu and the International classification of functioning.

Results: Of the infants exhibiting normal neurodevelopment (n = 183) or major dysfunction (n = 17) at 3 months of corrected age, 72% and 94% respectively did not change their score during the study. Minor dysfunctions at 3 months of corrected age were transient in 17 (34%) children. After adjustment for neonatal variables, neurodevelopment at 3 months of corrected age remained predictive of dysfunction at 36 months (odds ratio = 4.33, 95% confidence interval 2.05 to 9.12). If the results for the normal and minor dysfunction groups were pooled, the predictive qualities of the 3 month neurofunctional assessment were: sensitivity 0.5, specificity 0.99, positive predictive value 0.94, negative predictive value 0.93.

Conclusion: Early neurofunctional evaluation may be useful in predicting later neurodevelopmental outcome in VLBW children.

Abbreviations: AGA, appropriate size for gestational age; SGA, small for gestational age; VLBW, very low birth weight

Keywords: neurofunctional assessment; neurodevelopmental outcome; very low birthweight infants

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