Predictive value of neonatal brain MRI on the neurodevelopmental outcome of preterm infants by 5 years of age

Abstract

Aim: To study the prognostic value of MRI in preterm infants at term equivalent age for cognitive development at 5 years of age.Methods: A total of 217 very low birth weight/very low gestational age infants who all received brain MRI at term equivalent age were categorized into 4 groups based on the brain MRI findings. Cognitive development was assessed at 5 years of chronological age by using a short form of Wechsler Preschool and Primary Scale of IntelligenceRevised. This information was combined with neurosensory diagnoses by 2 years of corrected age.Results: Of all infants 31 (17.0%) had Full Scale Intelligence Quotient (FSIQ) <85, 14 (6.5%) had cerebral palsy and 4 (1.8%) had severe hearing impairment. A total of 41 (22.0%) infants had some neurodevelopmental impairment at 5 years of age. Considering cognitive outcome (FSIQ <85), the positive predictive value of several major MRI pathologies was 43.8%, and the negative predictive value of normal finding or minor pathologies was 92.0% and 85.7%, respectively.

The motor profile of preterm infants at 11 y of age

“…The existing data suggest that motor impairment in children with perinatal adversities is especially related to white matter abnormalities MRI (15). We have previously shown the predictive value of structural brain MRI at term age for neurosensory, cognitive and neurological outcome in very preterm born children at 2, 5, and 11 y of age (16)(17)(18). A recent study did not find correlations between brain volumes at term age and the Movement ABC-2 scores at age 5.5 y (19).…”

“…The reproducibility of these measurements was assessed by repeated volume measurement of 20 children, performed by another neuroradiologist, who was blinded for the results of the first measurement. These methods have been previously described in detail (16)(17)(18)20,25).…”

Preterm Birth and Poor Fetal Growth as Risk Factors of Attention-Deficit/Hyperactivity Disorder

“…As the vast majority of preterm infants today survive without major neurodevelopmental disabilities, 56,57 there is concern about the risk of later inattention/ hyperactivity and learning difficulties by school age and during adolescence. 58 Becoming aware of the long-term outcomes of children born late preterm is noteworthy, because ∼72% of infants born prematurely are born during that period (34-36 weeks).…”

Choosing Wisely in Newborn Medicine: Five Opportunities to Increase Value

“…17 There is, however, insufficient evidence that the routine use of term-equivalent or discharge screening brain MRIs in preterm infants improves long-term outcome. [18][19][20][21][22][23][24] …”