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General movements and magnetic resonance imaging in the prediction of neuromotor outcome in children born extremely preterm

General movements and magnetic resonance imaging in the prediction of neuromotor outcome in children born extremely preterm
General movements and magnetic resonance imaging in the prediction of neuromotor outcome in children born extremely preterm
BACKGROUND: Extremely preterm (EPT) birth is a major risk factor for brain injury and neurodevelopmental impairment. Reliable tools for early prediction of outcome are warranted.

AIM: To investigate the predictive value of general movements (GMs) at "fidgety age" for neurological outcome at age 30months in EPT infants, both in comparison and in combination with structural magnetic resonance imaging (MRI) at term equivalent age (TEA).

STUDY DESIGN: Fifty-three infants born <27weeks of gestation were included prospectively. MRI was performed at TEA and images were evaluated for white and grey matter abnormalities. GMs were assessed at age 3months corrected ("fidgety age").

OUTCOME MEASURES: Neuromotor outcome was assessed at age 30months corrected. Children were classified as having a normal neurological status, unspecific signs, or cerebral palsy (CP).

RESULTS: Abnormal GMs were a common finding, seen in 32% (17/53) of infants. Of these, six infants (11%) had definitely abnormal GMs. Four infants (8%) had a diagnosis of CP at follow up. Definitely abnormal GMs were significantly associated to CP at 30months (Fisher's Exact test p=0.03, sensitivity 50%, specificity 92%). Moderate-severe white matter abnormalities on MRI were more strongly associated with CP (Fisher's Exact test p<0.001, sensitivity 100%, specificity 98%) than GMs. Combining GMs with MRI-findings at TEA increased the predictive specificity to 100% (Fisher's Exact test, p=0.005), whereas sensitivity remained unchanged.

CONCLUSIONS: The presence of definitely abnormal GMs was predictive of CP: prediction was significantly enhanced when the GMs assessment was combined with findings from MRI obtained at TEA.
0378-3782
467-472
Skiöld, Béatrice
e0462ec7-9993-47b5-92bb-3db4edf06d2d
Eriksson, Christina
097237b5-4d89-49e1-9e48-b5228e78f568
Eliasson, Ann-Christin
94d59f21-a5bb-487d-957e-e3c421d3f2e7
Adén, Ulrika
32b79481-167d-47f1-9e38-c332da320a33
Vollmer, Brigitte
044f8b55-ba36-4fb2-8e7e-756ab77653ba
Skiöld, Béatrice
e0462ec7-9993-47b5-92bb-3db4edf06d2d
Eriksson, Christina
097237b5-4d89-49e1-9e48-b5228e78f568
Eliasson, Ann-Christin
94d59f21-a5bb-487d-957e-e3c421d3f2e7
Adén, Ulrika
32b79481-167d-47f1-9e38-c332da320a33
Vollmer, Brigitte
044f8b55-ba36-4fb2-8e7e-756ab77653ba

Skiöld, Béatrice, Eriksson, Christina, Eliasson, Ann-Christin, Adén, Ulrika and Vollmer, Brigitte (2013) General movements and magnetic resonance imaging in the prediction of neuromotor outcome in children born extremely preterm. Early Human Development, 89 (7), 467-472. (doi:10.1016/j.earlhumdev.2013.03.014). (PMID:23623716)

Record type: Article

Abstract

BACKGROUND: Extremely preterm (EPT) birth is a major risk factor for brain injury and neurodevelopmental impairment. Reliable tools for early prediction of outcome are warranted.

AIM: To investigate the predictive value of general movements (GMs) at "fidgety age" for neurological outcome at age 30months in EPT infants, both in comparison and in combination with structural magnetic resonance imaging (MRI) at term equivalent age (TEA).

STUDY DESIGN: Fifty-three infants born <27weeks of gestation were included prospectively. MRI was performed at TEA and images were evaluated for white and grey matter abnormalities. GMs were assessed at age 3months corrected ("fidgety age").

OUTCOME MEASURES: Neuromotor outcome was assessed at age 30months corrected. Children were classified as having a normal neurological status, unspecific signs, or cerebral palsy (CP).

RESULTS: Abnormal GMs were a common finding, seen in 32% (17/53) of infants. Of these, six infants (11%) had definitely abnormal GMs. Four infants (8%) had a diagnosis of CP at follow up. Definitely abnormal GMs were significantly associated to CP at 30months (Fisher's Exact test p=0.03, sensitivity 50%, specificity 92%). Moderate-severe white matter abnormalities on MRI were more strongly associated with CP (Fisher's Exact test p<0.001, sensitivity 100%, specificity 98%) than GMs. Combining GMs with MRI-findings at TEA increased the predictive specificity to 100% (Fisher's Exact test, p=0.005), whereas sensitivity remained unchanged.

CONCLUSIONS: The presence of definitely abnormal GMs was predictive of CP: prediction was significantly enhanced when the GMs assessment was combined with findings from MRI obtained at TEA.

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Published date: 25 April 2013
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 352161
URI: http://eprints.soton.ac.uk/id/eprint/352161
ISSN: 0378-3782
PURE UUID: e871f814-84f5-450c-b2ca-2b7191ac0c93
ORCID for Brigitte Vollmer: ORCID iD orcid.org/0000-0003-4088-5336

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Date deposited: 07 May 2013 12:05
Last modified: 18 Feb 2021 17:15

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