Published online November 1, 2007
PEDIATRICS Vol. 120 No. 5 November 2007, pp. 1012-1019 (doi:10.1542/10.1542/peds.2006-3364)
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ARTICLE

Twelve-Month Neurofunctional Assessment and Cognitive Performance at 36 Months of Age in Extremely Low Birth Weight Infants

Maria Lorella Giannì, MD, Odoardo Picciolini, MD, Chiara Vegni, MD, Laura Gardon, PT, Monica Fumagalli, MD and Fabio Mosca, MD

Neonatal Intensive Care Unit, Institute of Pediatrics and Neonatology, Fondazione IRCCS "Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena" University Medical School, Milan, Italy

OBJECTIVE. The objective of this study was to investigate whether an early neurofunctional assessment (at 12 months’ corrected age) is predictive of cognitive outcome at 36 months of age in extremely low birth weight infants.

METHODS. We conducted an observational longitudinal study. Neurodevelopmental outcome by means of a neurofunctional assessment was evaluated at 12 months’ corrected age and 36 months’ chronological age in 141 extremely low birth weight children. Cognitive outcome was assessed with use of the Griffiths Mental Developmental Scale.

RESULTS. A significant association was found between the 12-month neurofunctional status and cognitive performance at 36 months. A higher general quotient on the Griffiths Mental Developmental Scale at 36 months was observed in infants who exhibited normal (score: ≤1) neurodevelopment compared with children who exhibited minor (score: 2) and major (score: ≥3) dysfunctions at the 12-month neurofunctional evaluation (99 ± 6.8 vs 85.3 ± 16.3 vs 57.3 ± 22.0). A score of ≥2 at the 12-month neurofunctional assessment, abnormal brain MRI results at term, and chronic lung disease remained predictive of cognitive delay at 36 months of age and also after adjustment for confounders.

CONCLUSIONS. The 12-month neurofunctional evaluation may be an additional useful clinical tool in predicting later cognitive outcome in extremely low birth weight children.

Key Words: neurofunctional assessment • cognitive outcome • extremely low birth weight infants

Abbreviations: VLBW—very low birth weight • ELBW—extremely low birth weight • SGA—small for gestational age • NEC—necrotizing enterocolitis • ROP—retinopathy of prematurity • CLD—chronic lung disease • HC—head circumference • GQ—general quotient

Accepted May 29, 2007.


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