Neurophysiologic Maturation Index for Moderate and Late Preterm Infants

Inclusion Criteria:

- Gestational age of either 320-326 weeks or 340-346 weeks by Obstetric criteria
(presence of a sure LMP or sonogram performed in the first trimester, or agreement
between LMP and a sonogram performed between the first trimester and 20 weeks)

- Admitted to a NICU of a participating institution

- Post-natal age less than 96 hours

Exclusion Criteria:

- Major congenital anomaly/genetic anomaly

- Growth restriction (birth weight < 10%, Fenton growth curves)

- Unsure obstetric dating (e.g., absence of a sure LMP without a sonogram, earliest
sonogram performed after 20 weeks without a sure LMP, or discrepancy between LMP and
sonogram)

- Exposure to medications within the preceding 12 hrs which may affect CNS function
(e.g., fentanyl, morphine, midazolam)

- Neonatal seizures

- Neonatal abstinence syndrome secondary to in-utero exposure to narcotics, methadone
etc, or at high risk for development of abstinence

- Hypoxia-ischemia defined as the combination of fetal acidemia (cord gas or blood gas
within 1 hour of birth: pH ≤ 7.15 or BE ≥ -10mEq/L), need for resuscitation at birth
(PPV ± chest compressions or medications), and evidence of encephalopathy (Stage 1, 2
or 3 Sarnat). Stage 1 encephalopathy will be defined based on the level of
consciousness which is characterized by a hyper-alert state, apparent alertness, and
irritability. In the absence of a cord or early post-natal blood gas, there must be a
history of a perinatal event which may have compromised oxygenation or blood flow to
the fetus.

- Infants who are expected to be on mechanical (via an endotracheal tube) or high
frequency ventilation for the first 96 hours after birth.

- Inability to obtain the informed consent