Abstract
BackgroundThe predictive value of the combination of neurological examination and brain magnetic resonance imaging (MRI) or cranial ultrasound (cUS) in preterm infants is not known. AimsTo study the prognostic value of the combination of neurological examination and brain MRI at term equivalent age (TEA) or serial neonatal cUS in very preterm infants for neurosensory outcome at 2years of corrected age. Study designA prospective follow-up study. SubjectsA total of 216 very preterm infants (birth weight 1132g [SD 331g]) born in Turku University Hospital, from 2001 to 2006, were included. Outcome measuresThe Dubowitz neurologic examination and brain MRI were done at TEA, and serial cUS examinations were performed until TEA. The Hammersmith Infant Neurological Examination (HINE) and neurosensory impairments (NSI) were assessed at 2years of corrected age. ResultsOf all infants, 163 (76%) had one or more deviant neurological items at TEA, and 32 (15%) had the HINE total score below the 10th percentile at 2years of corrected age. A total of 17 (8%) infants had NSI. Neurological examination at TEA improved the negative and positive predictive values of brain MRI for NSI from 99% to 100%, and from 28% to 35%, respectively, and the negative and positive predictive values of cUS from 97% to 100%, and from 61% to 79%, respectively. ConclusionsThe combination of the Dubowitz neurologic examination and the brain MRI at TEA or serial neonatal cUS provides a valuable clinical tool for predicting long-term neurosensory outcome in preterm infants.
Published Version
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