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Neonatology pp 1–24Cite as

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

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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.

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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

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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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Authors and Affiliations

  1. Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI, USA

    Betty R. Vohr

  2. Women and Infants Hospital, 101 Dudley Street, Providence, RI, 02905, USA

    Betty R. Vohr

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  1. Betty R. Vohr
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Correspondence to Betty R. Vohr .

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  1. Siena, Italy

    Giuseppe Buonocore

  2. Medicina della Riproduzione, Università di Siena Dipto. Pediatria, Ostetricia e, Siena, Italy

    Rodolfo Bracci

  3. Liverpool Women's Hospital Neonatal Unit, Liverpool, United Kingdom

    Michael Weindling

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Vohr, B.R. (2016). Normal and Abnormal Neurodevelopmental and Behavioral Outcomes of Very Low-Birth Weight (VLBW) Infants. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-319-18159-2_266-1

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