Predictability of INFANIB and Amiel-Tison Neuromotor Assessments in the Follow-Up of High-Risk Neonates

Suman Rao PN, Maria Lewin, Saudamini Nesargi, Vijaya Raman, Swarnarekha Bhat

Abstract

Background and Aims: Neurologic assessment forms an integral part of follow-up of high-risk neonates. The available assessment methods have their own advantages and disadvantages.

The primary objective was to compare the predictability of Infant Neurological International Battery (INFANIB) and Amiel-Tison methods of neuromotor assessment with that of Developmental Assessment Scale for Indian Infants (DASII). The secondary objective was to determine the neurodevelopmental outcomes of neonates weighing < 1800 g at birth.

Materials and Methods: Neonates with birth weight < 1800 g at 40 weeks corrected age were enrolled. All participants were assessed both by INFANIB and Amiel-Tison methods at 40 weeks corrected age and 3, 6, 9, and 12 months corrected ages, by 2 different investigators. All infants were assessed by DASII at 12 to 15 months by a trained child psychologist. Data were statistically analyzed.

Results: Amiel-Tison method showed a higher sensitivity and specificity at 40 weeks corrected age for identifying infants with low motor developmental quotient (< 70). INFANIB method showed better sensitivity at 3, 6, 9, and 12 months corrected ages. Both the methods had a high negative predictive value (> 90%). Only 3 infants had a developmental quotient < 70 at 12 months corrected age. The mean motor and mental developmental quotients were 97.87 ± 21.8 and 89.64 ± 11.5, respectively.

No neonatal risk factor was significantly associated with abnormal neurologic outcome. In 69% of infants, transient neurologic abnormalities were detected by INFANIB, which normalized by 1 year.

Conclusions: INFANIB may be a good screening tool in early infancy and Amiel-Tison may be useful for confirming the neurologic abnormality. The developmental outcome of neonates with birth weight < 1800 g was good, with 93% being normal at 1 year.

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