Early prediction of neurological outcome by term neurological examination and cranial ultrasound in very preterm infants

Amess, P, McFerran, C, Khan, Y and Rabe, H (2009) Early prediction of neurological outcome by term neurological examination and cranial ultrasound in very preterm infants. Acta Pædiatrica, 98 (3). pp. 448-453. ISSN 1651-2227

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Abstract

AIM

To assess the value of term neurological examination and cranial ultrasound in the early prediction of neurological outcome at 12 months corrected age in a cohort of very preterm infants.

METHODS

A cohort of 102 preterm infants born at <32 weeks gestation or with a birth weight of <1500 g were assessed using the Hammersmith Term Neurological Examination. They underwent cranial ultrasound examinations according to local guidelines. The Hammersmith Infant Neurological Examination was performed at 12 months corrected age. Scores for the term examinations were compared with scores derived from healthy infants born at term and with scores from low-risk preterm infants at term equivalent age. Term neurological scores and cranial ultrasound findings were compared in the prediction of 12-month neurological outcome.

RESULTS

Seventy-eight (76.5%) preterm infants had suboptimal total neurological scores at term when compared to healthy infants born at term. However, most went on to have optimal neurological scores at 12 months corrected age. When our cohort was compared with low-risk preterm infants at term equivalent age only 14 (13.7%) scored outside the normal range. Neither system of scoring predicted neurological outcome at 12 months corrected age as reliably as cranial ultrasound (sensitivity 0.83, specificity 0.87).

CONCLUSION

Neurological examination of preterm babies at term may be unreliable in the prediction of neurological outcome at 12 months corrected age. For early prediction of neurological outcome cranial ultrasound examination was found to be more reliable.

Item Type: Article
Keywords: Cranial ultrasound; Neurological examination; Outcome; Preterm
Schools and Departments: Brighton and Sussex Medical School > Clinical Medicine
Subjects: R Medicine > RJ Pediatrics
Depositing User: Ellen Thomas
Date Deposited: 02 Nov 2012 10:29
Last Modified: 02 Nov 2012 10:29
URI: http://sro.sussex.ac.uk/id/eprint/41915
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