Prognostic value of the neurologic optimality score at 9 and 18 months in preterm infants born before 31 weeks' gestation

Frisone, Maria Flavia; Mercuri, Eugenio; Laroche, Sabrina; Foglia, Christine; Maalouf, Elia F.; Haataja, Leena; Cowan, Frances; Dubowitz, Lilly

doi:10.1067/mpd.2002.119626

Cited by 64 publications

(95 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless all infants with IVH grade III or CP had suboptimal NOS. Assessment of NOS was performed at a higher age than in previous study which may have affected the proportion of infants with a score defined as subnormal (18).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Inflammation at Birth is Associated With Subnormal Development in Very Preterm Infants

et al. 2008

View full text Add to dashboard Cite

Preterm birth carries a risk for impaired developmental outcome. We have previously described an association between increased levels of proinflammatory cytokines during the first 72 postnatal hours and cerebral damage as detected by ultrasound in a cohort of 74 very preterm infants. Sixty-seven of 71 surviving children with a mean gestational age of 27.1 (2.0) wk were examined at 2 y corrected age with a standardized neurologic examination and with Bayley Scales of Infant Development. We hypothesized that proinflammatory cytokine concentrations at or shortly after birth would be associated with an adverse developmental outcome. Increased concentrations of TNF-␣ in cord blood odds ratio (95% confidence interval) 3.3 (1.1-10.2), p ϭ 0.013 and at 6 h 7.8 (0.9 -71.8), p ϭ 0.015 and of IL-6 in cord blood 1.7 (1.0 -2.9), p ϭ 0.048 were associated with psychomotor developmental index Ͻ85. Increased concentrations of TNF-␣ in cord blood odds ratio (95% confidence interval) 3.6 (1.002-12.8), p ϭ 0.044 and of IL-8 in cord blood 3.5 (1.2-10.6), p ϭ 0.023 were associated with cerebral palsy. Associations of TNF-␣ and IL-8 in cord blood with the respective outcome measures remained significant after adjustment for other clinical variables. Proinflammation at birth is associated with impaired functional outcome at 2 y of corrected age in children with very preterm birth. (Pediatr Res 64: 183-188, 2008)

show abstract

Section: Discussionmentioning

confidence: 99%

“…Neurologic assessment was performed by a neonatalist (I.H.-P.), using the Hammersmith Infant Neurologic examination, which is a method previously optimized for assessment of infants and children between 2 and 18 mo of age (18). The method is based on 26 items where each item is scored separately.…”

Section: Methodsmentioning

confidence: 99%

Inflammation at Birth is Associated With Subnormal Development in Very Preterm Infants

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Prediction on the basis of a single infant examination is most useful when it is aimed at the detection of children with a clear dysfunction, such as CP. 7,31,32 Early prediction of MND on the basis of a single assessment is more difficult, notwithstanding the fact that signs of MND during infancy are related to MND in later life. 6,33 CONCLUSION MND can be assessed reliably during infancy with the TINE.…”

Section: Discussionmentioning

confidence: 99%

The assessment of minor neurological dysfunction in infancy using the Touwen Infant Neurological Examination: strengths and limitations

Hadders‐Algra

Heineman

Bos

et al. 2009

Develop Med Child Neuro

View full text Add to dashboard Cite

AIM Little is known of minor neurological dysfunction (MND) in infancy. This study aimed to evaluate the inter-assessor reliability of the assessment of MND with the Touwen Infant Neurological Examination (TINE) and the construct and predictive validity of MND in infancy.METHOD Inter-assessor agreement was determined in a sample of 40 infants (24 males, 16 females) aged 3 to 12 months (25 born at term: gestational age 37-41wks, median 39; and 15 born preterm, gestational age 24-35wks, median 32). Thirty typically developing term infants (18 males, 12 females; gestational age 37-42wks, median 40) and 59 preterm infants (34 males, 25 females) born at <35 weeks' gestation (gestational age 25-34wks, median 29) participated in the validity study. They were neurologically assessed with the TINE at the corrected ages of 4, 6, 10, and 12 months and with the Hempel assessment at 18 months. RESULTSThe findings indicated that MND can be assessed reliably (inter-assessor agreement: kappa=0.83). MND during infancy was related to prenatal, perinatal, and social factors, and in particular to preterm birth. Neurological condition during infancy was prone to change, but was related to neurological condition at 18 months at all ages tested. INTERPRETATIONWe conclude that MND can be determined reliably in infancy. Important considerations in the construct of MND in infancy are its relation to prenatal and perinatal factors, its limited stability, and its moderate predictive value.Neurological assessment is one of the clinical tools used to monitor development in infants at risk for developmental disorders, such as infants born preterm. Multiple methods are available, such as the Amiel-Tison neurological examination, 1 the Touwen Infant Neurological Examination (TINE), 2 the Hammersmith Infant Neurological Examination (HINE), 3 and the neurofunctional assessment of Picciolini et al. 4 Little is known about the reliability of these widely used methods. 5 The validity of neurological assessments has been studied to some extent; marked neurological dysfunction during infancy has considerable power to predict developmental disability such as cerebral palsy (CP). [5][6][7] However, knowledge about the significance of signs of minor neurological dysfunction (MND) during infancy is scarce.Our knowledge of MND is based in particular on data of children above preschool age. Two distinct forms of MND have been distinguished: simple and complex MND.8 Before the onset of puberty the distinction is based on the number of dysfunctions present; after the onset of puberty classification is based on the type of dysfunction. Simple MND may be regarded as the expression of a normal but non-optimally functioning nervous system (minor neurological difference). In contrast, complex MND is the form of MND which is strongly related to pre-and perinatal adversities and to learning and behavioural disorders. From an aetiological point of view, this suggests that it may be considered as a borderline form of CP.8 It is uncertain whether the concept of simple ...

show abstract

“…Previous studies reported the presence of incomplete FPR at 12 months both in term 6 and preterm low-risk infants. 9,23 By following infants with brain lesions at later ages, we found evidence of a further-delayed maturation of the FPR, even after 24 months of age. This can be considered as the expression of an immature pattern of sensory motor development.…”

Section: Discussionmentioning

confidence: 84%

The forward parachute reaction and independent walking in infants with brain lesions

Romeo¹,

Ricci²,

Baranello³

et al. 2011

Developmental Medicine &Amp; Child Neurology

Self Cite

View full text Add to dashboard Cite

FPRForward parachute reaction AIM The aim of this study was to assess the onset of forward parachute reaction (FPR) in infants with brain lesions and its correlation with age of walking.METHOD FPR was assessed at 6, 9, and 12 months in 140 infants with brain lesions (78 males, 62 females; mean gestational age 31wks; SD 3.6wks; mean birthweight 1450g, SD 252g). On cranial ultrasound 62 infants had mild and 78 had major abnormalities; 86 developed cerebral palsy. All were followed for 5 years, and the age at which each child achieved independent walking was recorded. Infants who had been born small for gestational age (weight <10th centile) were excluded, as were those who had major congenital malformations, severe postnatal infectious diseases, or metabolic or haematological complications.RESULTS A complete FPR was present in eight infants at 6 months, in 42 at 9 months, and in 71 at 12 months. At 12 months, 29 infants presented incomplete FPR and 40 presented absent FPR. Seventy-three infants were able to walk independently between the ages of 11 months and 60 months (67 with complete FPR and six with incomplete FPR at 12mo). A complete FPR at 12 months was a good predictor of independent walking. The age at onset of complete FPR was also a good predictor of age of walking. INTERPRETATIONThe late acquisition of a complete FPR appears to be an early sign of a more general delayed maturation of functional abilities.

show abstract

Prognostic value of the neurologic optimality score at 9 and 18 months in preterm infants born before 31 weeks' gestation

Cited by 64 publications

References 18 publications

Inflammation at Birth is Associated With Subnormal Development in Very Preterm Infants

Inflammation at Birth is Associated With Subnormal Development in Very Preterm Infants

The assessment of minor neurological dysfunction in infancy using the Touwen Infant Neurological Examination: strengths and limitations

The forward parachute reaction and independent walking in infants with brain lesions

Contact Info

Product

Resources

About