The Perinatal Risk Inventory can be used to identify infants who are at risk for significant developmental abnormalities. The study was done at the University of Massachusetts.
Parameters:
(1) Apgar score
(2) EEG
(3) seizures (nonmetabolic)
(4) intracranial hemorrhage
(5) hydrocephalus (evidence of increased pressure)
(6) CT or ultrasound without evidence of hydrocephalus or intracranial hemorrhage, but other CNS findings
(7) premature with weight > 3rd percentile (appropriate for gestational age); if score < 10th percentile, use item 8
(8) weight for gestational age (Dubowitz or estimated date of confinement)
(9) dysmorphic features
(10) ventilation
(11) head growth (premature infant hospitalized 6 weeks or more)
(12) head growth (term infant hospitalized > 3 weeks)
(13) polycythemia (venous hematocrit)
(14) meningitis
(15) hypoglycemia (regardless of gestational age, < 1.7 mmol/L [30 mg/dL] on heelstick)
(16) congenital infection
(17) hyperbilirubinemia
(18) associated non-CNS medical problems such as hydrops, retinopathy of prematurity (ROP), cyanotic heart disease, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis
where:
• I think item 6 might be better termed: CNS findings other than hydrocephalus and intracranial hemorrhage.
• I am confused by some of the wording in items 7 and 8 but will assume that both can be scored although 7 would only be scored if premature
• items 11 and 12 (head growth): only 1 applies
|
Parameter |
Finding |
Points |
|---|---|---|
|
Apgar score (see below) |
no neurobehavioral abnormalities |
0 |
|
|
hyperalert |
1 |
|
|
mild hypotonia |
2 |
|
|
severe hypotonia |
3 |
|
EEG |
EEG not performed |
0 |
|
|
normal EEG |
0 |
|
|
abnormal EEG but normal at discharge |
1 |
|
|
abnormalities on EEG (not flat or periodic) with continued abnormalities at discharge |
2 |
|
|
periodic or flat EEG with continued abnormalities at discharge |
3 |
|
seizures (nonmetabolic) |
no problem |
0 |
|
|
suspected seizure; not treated with anticonvulsants |
1 |
|
|
1 or more seizures with response to a single anticonvulsant |
2 |
|
|
1 or more seizures with resistance to therapy requiring 2 or more anticonvulsants |
3 |
|
intracranial hemorrhage |
CT scan or ultrasound not performed |
0 |
|
|
CT scan or ultrasound negative |
0 |
|
|
subarachnoid hemorrhage with seizures |
1 |
|
|
grade I intraventricular hemorrhage (IVH) |
1 |
|
|
grade II intraventricular hemorrhage |
1 |
|
|
grade III intraventricular hemorrhage |
2 |
|
|
grade IV intraventricular hemorrhage |
3 |
|
hydrocephalus |
no evidence of hydrocephalus on ultrasound or CT scan |
0 |
|
|
suspected on clinical basis; resolved without treatment |
1 |
|
|
hydrocephalus confirmed on ultrasound or CT scan without shunt; treated medically or repeated intraventricular taps |
2 |
|
|
hydrocephalus confirmed on ultrasound or CT scan with shunt required |
3 |
|
CNS findings without hydrocephalus or intracranial hemorrhage |
CT scan or ultrasound not done |
0 |
|
|
CT scan or ultrasound negative |
0 |
|
|
abnormal findings with return to normal prior to discharge |
1 |
|
|
identified abnormalities not specified elsewhere without return to normal prior to discharge |
2 |
|
& InfoSpecialty: Pedatrics ICD-10: , |
