Prediction of growth and development in intensive care nursery graduates at 12 months of age

E. J. Sell, S. Hill, S. S. Poisson, E. Williams and J. A. Gaines

Although many perinatal events have been linked with the outcome status of neonatal intensive care unit (NICU) graduates, few studies have evaluated the cumulative longitudinal prediction of outcome. This study followed up 65 term and 139 premature NICU graduates to 12 months' chronologic age. Variables that were utilized in predicting 12-month growth and the neurologic and developmental outcome were maternal and neonatal medical factors, prior growth measurements, and neonatal behavior, which was measured with the Brazelton Scale for term infants and with a modified version for premature infants. The neurologic status was normal in 141 (71.9%) of 204 infants. The average Bayley Scale Mental Developmental Index was 112.7, and the average Psychomotor Developmental Index was 97.5, which was corrected for early gestation. Predictions of 12-month neurologic and developmental status were weak and had been derived only by variables from the neonatal behavioral examination; endurance predicted neurologic status and the motor cluster predicted cognitive and motor development. The prediction of growth at 12 months was high and was derived from prior growth parameters. Thus, although predictions of neurodevelopmental status at 12 months' chronologic age were low, the variables that aided in predicting were from the neonatal behavioral evaluation. This finding provides support for recommending that the functional status of the NICU graduate as well as the more traditional list of perinatal problems be considered when contemplating the infants' short-term outcome.