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Neuroimaging and Neurodevelopmental Outcome in Extremely Preterm Infants
- Source :
- Pediatrics. 135:e32-e42
- Publication Year :
- 2015
- Publisher :
- American Academy of Pediatrics (AAP), 2015.
-
Abstract
- BACKGROUND: Extremely preterm infants are at risk for neurodevelopmental impairment (NDI). Early cranial ultrasound (CUS) is usual practice, but near-term brain MRI has been reported to better predict outcomes. We prospectively evaluated MRI white matter abnormality (WMA) and cerebellar lesions, and serial CUS adverse findings as predictors of outcomes at 18 to 22 months’ corrected age. METHODS: Early and late CUS, and brain MRI were read by masked central readers, in a large cohort (n = 480) of infants RESULTS: Of 480 infants, 15 died and 20 were lost. Increasing severity of WMA and significant cerebellar lesions on MRI were associated with adverse outcomes. Cerebellar lesions were rarely identified by CUS. In full multivariable models, both late CUS and MRI, but not early CUS, remained independently associated with NDI or death (MRI cerebellar lesions: odds ratio, 3.0 [95% confidence interval: 1.3–6.8]; late CUS: odds ratio, 9.8 [95% confidence interval: 2.8–35]), and significant gross motor impairment or death. In models that did not include late CUS, MRI moderate-severe WMA was independently associated with adverse outcomes. CONCLUSIONS: Both late CUS and near-term MRI abnormalities were associated with outcomes, independent of early CUS and other factors, underscoring the relative prognostic value of near-term neuroimaging.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Developmental Disabilities
Visual impairment
Neuroimaging
medicine
Humans
Prospective Studies
Prospective cohort study
medicine.diagnostic_test
business.industry
Infant, Newborn
Brain
Infant
Magnetic resonance imaging
Odds ratio
Echoencephalography
Magnetic Resonance Imaging
Confidence interval
Infant, Extremely Premature
Pediatrics, Perinatology and Child Health
Gestation
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 10984275 and 00314005
- Volume :
- 135
- Database :
- OpenAIRE
- Journal :
- Pediatrics
- Accession number :
- edsair.doi.dedup.....7ce7eaa1171c4835af910097212c879e