Synopsis of resource:
NICU survivors who are between 32-37 weeks are almost 11% of the population & are more in nos than very preterm children. At term‐equivalent age, infants born moderate‐to‐late preterm (MLPT) have poorer brain growth and maturation, as seen via magnetic resonance imaging (MRI), compared with peers born at term
There is a growing concern as poor school performance & need for special education has been reported among them. In this longitudinal prospective study, 201 infants born during a 3yr period were recruited at term equivalent age and evaluated with HNNE & NNNS & at 2yrs with Bayley-III and correlations with motor, cognitive and behaviours were noted
Suboptimal performance on the lethargy and Excitability scale of NNNS and HNNE are associated with worse cognitive outcomes at 2yrs and Suboptimal performance on the lethargy scale alone is associated with motor & language delay at 2yrs It is worthwhile using these simple clinical assessments at term equivalent ages in this vulnerable group to institute early intervention measures and decrease health burden in later years
Key learning outcomes
- Moderately low preterm babies [MLPT] <37 weeks form 11% of births. Evaluation at birth and at 2 years is important for picking up functional impairments
- Hammersmith neonatal neurological examination[HNNE} & NICU network neuro behavioural assessments[NNNS] at term equivalent age in MLPT are comparable with Bayley-III at 2yrs with relation to motor, cognitive & language delay.
- Early recognition helps instituting early intervention exploiting sensitive neuroplastic phase for optimal recovery.
Authors
Associate Professor Alicia Spittle is a paediatric physiotherapist and international leader in early detection of motor impairments and early intervention for infants at high risk of developmental impairments. She is Director of Paediatric Physiotherapy Research at the University of Melbourne and an National Health and Medical Research Council Career Development Fellow.
She is a passionate researcher who leads the motor team within the Victorian Infant Brain Studies (VIBeS) group at Murdoch Childrens Research Institute, along with holding a clinical appointment at the Royal Women’s Hospital, Melbourne. She is the first Australian tutor of the General Movements Assessment and is leading a collaboration with an international team of experts to use innovative technology to improve access to early detection of cerebral palsy.
