Prediction of outcome at school age in neonatal intensive care unit graduates using neonatal neurologic tools

Prediction of outcome for neonatal intensive care unit graduates is clinica lly useful to counsel families effectively and target those who may benefit from early interventions. Evoked potentials have proven prognostic value o f neurologic outcomes in early childhood; however, their long-term predicti ve validity remains to be determined. The objective of this prospective stu dy was to determine the long-term predictive value of three neonatal neurol ogic assessments: brainstem auditory evoked potentials, somatosensory evoke d potentials, and the Einstein Neonatal Neurobehavioral Assessment Scale. S eventy-eight high-risk newborns and 28 healthy controls were recruited and were assessed in the newborn period using these tests. At 8 to 9 years of a ge, 42 subjects and 13 controls were re-evaluated for developmental progres s using a range of psychologic, sensorimotor; and neurologic measures. Find ings indicated that the somatosensory evoked potential was most accurate at predicting outcome at school age, with high specificity (83-100%) across a ll domains tested and good sensitivity (80-100%) for intellectual performan ce and sensorimotor abilities. The brainstem auditory evoked potential was limited by false-negatives, whereas the neonatal neurobehavioral assessment yielded many false-positives. This study provides new evidence that associ ations between neonatal somatosensory evoked potentials and developmental s equelae continue to be significant at school age.