Neurological assessment of preterm infants for predicting neuromotor status at 2 years: results from the LIFT cohort

Abstract

ObjectiveTo develop a predictive risk stratification model for the identification of preterm infants at risk of 2-year suboptimal neuromotor status.DesignPopulation-based observational study.SettingRegional preterm infant follow-up programme (Loire Infant Follow-up Team (LIFT) cohort) implemented in 2003.Participants4030 preterm infants were enrolled in the LIFT cohort, and examined by neonatologists using a modified version of the Amiel-Tison neurological assessment tool.Main outcome criteria2 year neuromotor status based on clinical examinations was conducted by trained paediatricians and parents’ responses to the Ages and Stages Questionnaire were reported.ResultsAt 2 years of corrected age, 3321 preterm infants were examined, and suboptimal neuromotor status was found in 355 (10.7%). The study population was divided into training and validation sets. In the training set, 13 neonatal neurological items were associated with a 2-year suboptimal neuromotor status. Having at least one abnormal item was defined as an abnormal neurological status at term. In the validation set, these data predicted a 2-year suboptimal neuromotor status with a sensitivity of 0.55 (95% CI 0.47 to 0.62) and a specificity of 0.65 (95% CI 0.62 to 0.67). Two predictive risk stratification trees were built using the training set, which were based on the neurological assessment at term along with either gestational age or severe cranial lesions or birth weight. Using the validation set, the first tree identified a subgroup with a relatively low risk of suboptimal neuromotor status (3%), representing 32% of infants, and the second tree identified a subgroup with a risk of 5%, representing 42% of infants.ConclusionA normal neurological assessment at term allows the identification of a subgroup of preterm infants with a lower risk of non-optimal neuromotor development at 2 years.

Neonatal EEG and neurodevelopmental outcome in preterm infants born before 32 weeks

“…The neurological assessment at discharge was performed by a trained neonatologist using the Amiel–Tison method and was classified into four categories from normal to severely abnormal as previously published 4. The brain imaging protocol comprised sequential cranial ultrasound (CUs): at least one during the first week of life, then every 2 weeks until the fourth week of life or 32 weeks of postmenstrual age (PMA).…”

Early growth and neurodevelopmental outcome in very preterm infants: impact of gender

“…Data source constituted the Loire Infant Follow-up Team (LIFT)10 cohort which is a cohort of infants born in one region (Pays de la Loire, a region in western France) and enrolled in the regional follow-up network. All preterm infants less than 33 weeks are included in the cohort.…”

Neurobehavioral development prior to term-age of preterm infants and acute stressful events during neonatal hospitalization

“…Developmental assessments are usually performed after discharge before 2 years of age [15,16], during childhood [17,18], during adolescence [19], and even in adulthood [20].…”