| Nursery Neurobiologic Risk Score: important factor in predicting outcome in very low birth weight infants. | |
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MedLine Citation:
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PMID: 2019935 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We developed a nursery Neurobiologic Risk Score (NBRS) based on potential mechanisms of brain cell injury in preterm infants and correlated it with developmental outcome at the corrected ages of 6, 15, and 24 months. The NBRS was determined at 2 weeks of age and at the time of discharge from intensive care in 58 preterm infants with birth weights less than or equal to 1500 gm. The NBRS correlated significantly with the Bayley Scales of Infant Development, Mental Development Index (MDI) (r = -0.61 to -0.40) and Psychomotor Development Index (PDI) (r = -0.59 to -0.46), and with abnormal neurologic examination findings (r = 0.59 to 0.73) at the three testing periods. Although 12 of the 13 items composing the NBRS individually correlated with one or more outcome variables, seven items (infection, blood pH, seizures, intraventricular hemorrhage, assisted ventilation, periventricular leukomalacia, and hypoglycemia) accounted for almost all of the explained variance. Logistic regression of individual items demonstrated intraventricular hemorrhage to be the most important item for predicting the MDI at 24 months; pH was the most influential item for predicting the PDI at every testing period. A shorter, revised NBRS that included only the seven significant items demonstrated as strong a correlation with developmental outcome as the original NBRS. A revised 2-week score of greater than or equal to 5 or a discharge score of greater than or equal to 6 demonstrated 100% specificity and had a 100% positive predictive value for an abnormal outcome at 24 months of age in this group of infants. We conclude that the NBRS identifies during the intensive care nursery stay those infants at highest risk for an abnormal outcome related to nursery events. In addition, analysis of NBRS items provides insight into the relative importance of individual factors for influencing mental, motor, and neurologic outcome. |
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Authors:
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J E Brazy; C O Eckerman; J M Oehler; R F Goldstein; A M O'Rand |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of pediatrics Volume: 118 ISSN: 0022-3476 ISO Abbreviation: J. Pediatr. Publication Date: 1991 May |
Date Detail:
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Created Date: 1991-05-30 Completed Date: 1991-05-30 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 783-92 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatrics, Duke University, Durham, North Carolina. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Brain Damage, Chronic
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diagnosis*,
epidemiology Child Development* Child, Preschool Evaluation Studies as Topic Humans Infant Infant, Low Birth Weight* Infant, Newborn Neurologic Examination Nurseries, Hospital Physical Examination Prognosis Psychomotor Performance Regression Analysis Risk Factors |
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