59 - Can Neonatal Assessment Manual scorE (NAME index) identify subgroups of neonates that change their clinical condition over time and correlate with the occurrence of clinically relevant events?

Poster Number: 59
Publication Number: 59.189

Background: The Neonatal Assessment Manual scorE (NAME) is a touch-based procedure devised to aid the evaluations of preterm infants in NICUs. Previous papers have shown its rationale, validity, reliability, and its correlation with the infants’ clinical conditions. We hypothesize that NAME might help in identifying infants with different characteristics (e.g. good, marginal and bad) and development trajectories.

Objective: Primary objective: to determine whether infant subgroups differing by how the NAME score changes over time could be identified. Secondary objectives: to assess 1) whether the subgroups differ by demographical characteristics; 2) whether NAME evaluations correlate with the occurrence of clinically relevant events (CREs).

Design/Methods: This study followed a longitudinal design. From September 2021 to July 2023, 36 infants (≥24 and ≤37 weeks’GA) were enrolled in the NICU of the V. Buzzi Children Hospital in Milan, Italy. For each infant, NAME scores were collected during each hospitalization week until discharge and analyzed through group-based trajectory modeling (GBTM); explorative analyses were carry out to assess differences in demographical data between the identified subgroups. For each week, the change between the current and the previous NAME score was calculated (Δ score) and the occurred CREs were recorded: regression analyses were then performed between Δ score and both CREs occurrence and their “quality” (i.e., negative, neutral, or positive).

Results: GBTM analysis showed that three distinct subgroups can be identified based on the first 5 NAME evaluations for each infant. This model was chosen by analyzing: its resemblance to the actual behavior of infants in NICU; the Akaike information criterion value; the average posterior probabilities of subgroup membership (i.e., 0.93, 0.99, 0.89). The three subgroups were found to differ for the presence of IUGR (p=0.001).
Regarding the Δ score, remaining in the Bad category and passing from Bad to Marginal showed a higher CREs occurrence (respectively, OR=15.8 [1.9, 351.6], p=0.025, and OR=11.6 [1.6, 240.7], p=0.036) (Table 1), whereas an increase in the numerical NAME score was correlated with higher neutral/positive CREs occurrence (OR=1.63 [1.04, 2.56], p=0.019).

Conclusion(s): Infant subgroups with different NAME trajectories and characteristics were found. The NAME scales showed significant correlations with the occurrence of CREs and their quality. Therefore, the NAME procedure has the potential for improving communication between NICU professionals and NICU standard care.