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Neonatology pp 2031-2054 | Cite as

Normal and Abnormal Neurodevelopmental and Behavioral Outcomes of Very Low-Birth Weight (VLBW) Infants

  • Betty R. Vohr
Reference work entry

Abstract

Advances in perinatal and neonatal management of very low-birth weight (VLBW) infants (<1500 g) have resulted in increased survival of fragile “high-risk” infants, including those with extremely low birth weight (<1000 g). These high-risk preterm survivors have increased post-discharge morbidities including neurologic/neurosensory, cognitive, visual motor/fine motor, speech and language, motor function/coordination, functional skills for daily living, and behavior sequelae. Most tertiary care programs in the United States and all neonatal training programs have a structured follow-up program whose primary areas of responsibility are surveillance and research. Multiple assessment tools are used by these follow-up programs to identify the neurodevelopmental sequelae of preterm birth. Assessments in the first 3 years of life reliably identify major neurosensory morbidities and major neurodevelopmental sequelae. The majority of major abnormalities can be identified by 18–24 months of age. These early childhood assessments are often the primary outcome for clinical trials and also facilitate referral to appropriate intervention services. Although there are data demonstrating neurodevelopmental recovery with increasing age, there is also evidence of sustained adverse outcomes of executive functions, atypical behavior, and psychological problems into school age and adolescence. Assessments at school age rather than early childhood are felt to provide a more reliable prediction of long-term outcomes.

Abbreviations

ABR

Auditory brainstem response

ASD

Autism spectrum disorder

Bayley II

Bayley Scales of Infant Development II

BDI

Battelle Developmental Inventory

Beery VMI

Beery Developmental Test of Visual Motor Integration 4th Ed

BPD

Bronchopulmonary dysplasia

BSID-III

Bayley Scales of Infant Development III

CBCL

Child Behavior Checklist

CP

Cerebral palsy

DCD

Developmental coordination disorder

ELBW

Extremely low birth weight

ELM2

Early Language Milestone Scale2

ESP

Early Screening Profiles

GMFCS

Gross Motor Function Classification System

HL

Hearing loss

IVH

Intraventricular hemorrhage

MABC

Movement Assessment Battery for Children

M-CHAT

Modified Checklist for Autism in Toddlers

MDI

Mental Developmental Index

NDI

Neurodevelopmental impairment

NICHD

National Institute of Child Health and Human Development

NICU

Neonatal intensive care unit

PDDST II

Pervasive Developmental Disorders Screening Test II

PDI

Psychomotor Developmental Index

PDMS

Peabody Developmental Motor Scales

PLS

Preschool Language Score

PPVT-R

Peabody Picture Vocabulary Test

PVL

Periventricular leukomalacia

SB-4

Stanford-Binet Intelligence Scale, 4th edition

SICDR

Sequenced Inventory of Communication Development Revised

VABS

Vineland Adaptive Behavior Scale

VLBW

Very low birth weight

WeeFIM

Functional Independence Measure for Children

WISC-III

Wechsler Intelligence Scale for Children

WPPSI

Wechsler Preschool and Primary Scales of Intelligence

Notes

Acknowledgments

We gratefully acknowledge the contribution of Bonnie E. Stephens MD to the 2009 edition of Normal and Abnormal Neurodevelopmental and Behavioral Outcomes of Very Low Birth Weight Infants.

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PediatricsThe Warren Alpert Medical School of Brown UniversityProvidenceUSA
  2. 2.Women and Infants HospitalProvidenceUSA

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