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Predicting neurodevelopmental impairment in preterm infants by standardized neurological assessments at 6 and 12 months corrected age
Author(s) -
Grimmer I,
Metze BC,
Walch E,
Scholz T,
Bührer C
Publication year - 2010
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2009.01649.x
Subject(s) - medicine , cerebral palsy , pediatrics , predictive value , motor impairment , physical therapy , physical medicine and rehabilitation
Abstract Aim: Neurodevelopmental impairment in very preterm infants can be reasonably diagnosed by 18–24 months corrected age, whereas the predictive value of earlier assessments is debated. We hypothesized that neurological findings at 6 and 12 months indicative of subsequent cerebral palsy predict 18–24 months’ neurodevelopmental impairment. Methods: Neurodevelopmental examinations (Griffiths scales) at 20 months of age in 561 preterm infants (birth weight <1 500 g) were compared with results of standardized neurological examinations (Early Motor Pattern Profile; EMPP) and Griffiths scales at 6 (n = 451) and 12 months (n = 496) corrected age. Results: Griffiths developmental quotients at 20 months were weakly but significantly related to EMPP scores at 6 (R s = 0.328) and 12 months (R s = 0.493). Areas under receiver operator characteristic curves for the EMPP to predict neurodevelopmental impairment (Griffiths scores ≤75) at 20 months were 0.772 (0.890) at 6 (12) months, compared to 0.915 (0.962) for Griffiths scores. By contrast, EMPP and Griffiths scores had equal power to predict unability to walk unaided at 2 years of age (EMPP 6/12 months: 0.946/0.983; Griffiths 6/12 months: 0.935/0.985). Conclusion: Neurological examinations with the EMPP at 6 and 12 months corrected age are of limited value to predict neurodevelopmental impairment at 20 months.