The aim of this study was to confirm the predictive value of the nursery Neurobiologic Risk Score. Prospectively, 121 infants (mean birthweight 961 +/- 179 g, gestation 27.0 +/- 1.2 weeks) were followed at 18 months. The nursery Neurobiologic Risk Score was correlated to the developmental quotient (r = -0.54). From low (scores 0-4), to moderate (scores 5-7) to high (scores > or = 8) risk groups, respectively, significant differences were found in mean developmental quotient (101 +/- 9 vs 92 +/- 19 vs 76 +/- 24) and in prevalence of developmental quotients < 90 (12 vs 24 vs 71%), of cerebral palsy (4 vs 19 vs 41%), of severe disabilities (0 vs 24 vs 50%) and of any disability (16 vs 30 vs 71%). Sensitivity, specificity, positive and negative predictive values for any disability were 81, 54, 49 and 84% for a score > or = 5 and 56, 87, 71 and 78% for a score > or = 8. The nursery Neurobiologic Risk Score was useful in predicting 18 months outcome of very premature infants.