A standardized approach to routine cranial ultrasonography in preterm infants: Improved neuromotor outcome predictability at 2 years and communication with parents

Abstract

Aim: The aim of this study is to evaluate the predictive value of routine cranial ultrasonography in preterm infants under 32 weeks' gestation with their neuromotor outcome at 2 years. Methods: This was a prospective, single-center, cohort study of preterm infants under 32 weeks' gestation. Each infant had an early (within 1 week of birth) and late (at 6 weeks postnatal age) cranial ultrasound scan performed. Each infant's scan result was independently assessed for the presence of major cranial abnormalities, such as intraventricular hemorrhage Grade 3 or 4, cystic periventricular leukomalacia, and porencephalic cyst. All surviving infants who returned for follow-up at 2 years' corrected age had their neuromotor development assessed using the Bayley Scales of Infant Development. The predictive value of major cranial abnormalities for the neuromotor delay was derived. Results: A total of 134 infants were included over 2 year. Of the 89 children with no major abnormality, 78 did not have a significant neuromotor delay, giving a negative predictive value of 87.6%. Of the six children with major abnormalities, two had a significant neuromotor delay, giving a positive predictive value of 33.3%. Conclusions: The absence of a major abnormality on quality-controlled routine cranial ultrasound scan in preterm infants under 32 weeks' gestation appears to be a good predictor of no significant abnormality in neuromotor development at 2 years of age.