Published online June 1, 2007
PEDIATRICS Vol. 119 No. 6 June 2007, pp. e1342-e1350 (doi:10.1542/peds.2005-2857)

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ARTICLE

Visual Function at 11 Years of Age in Preterm-Born Children With and Without Fetal Brain Sparing

Joke H. Kok, PhD, MD^a, Liesbeth Prick, PhD, MD^b, Elly Merckel^b, Yolande Everhard^b, Gijs J.Q. Verkerk^c and Sicco A. Scherjon, PhD, MD^d

^a Departments of Neonatology
^b Ophthalmology
^c Rehabilitation, Emma Children's Hospital and Academic Medical Center, Amsterdam, Netherlands
^d Department of Obstetrics, Leiden University Medical Center, Leiden, Netherlands

OBJECTIVE. We have demonstrated earlier an accelerated maturation of the visual evoked potential in the first year of life in preterm infants with antenatal brain sparing. We have now assessed visual functioning at 11 years of age in the same cohort and compared the groups with and without brain sparing.

DESIGN/METHODS. One hundred sixteen survivors included in a study on the outcome of preterm infants born at <33 weeks' gestation with and without fetal brain sparing and admitted to the NICU were followed extensively. Ninety-eight infants (85%) were again assessed at 11 years of age. Data were available for fetal Doppler measurements indicating brain sparing, neonatal cerebral ultrasound scanning, and developmental outcome in the first 5 years. Mean birth weight was 1303 g; mean gestational age was 29.8 weeks. The infants were divided into 2 groups with and without brain sparing. Visual functioning was estimated by measuring visual acuity, visual fields, eye position, and binocular function and by visual motor tests.

RESULTS. Six percent of the children were found to have a visual acuity of <0.8, 12% had strabismus, and 14% to 46% showed abnormal results on the visual motor tests. No statistical differences were found between the 2 groups. However, children with severe cerebral ultrasound diagnoses in the neonatal period were found to have significantly more abnormalities on visual functioning and lower scores on visual motor tests than children without these morbidities.

CONCLUSIONS. Children with fetal brain sparing do not demonstrate a different development of their visual functioning at late school age. However, an abnormal cerebral ultrasound in the neonatal period is associated with impaired visual function in later life.

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Key Words: very low birth weight infant • fetal brain sparing • developmental outcome • visual function • intrauterine growth retardation

Abbreviations: IUGR—intrauterine growth restriction • ICH—intracranial hemorrhage • ROP—retinopathy of prematurity • VMI—visual motor integration • U/C—umbilical/cerebral • MAT—Motor Accuracy Test • MVPT-R—Motor-Free Visual Perception Test, Revised • Movement ABC—Movement Assessment Battery for Children

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Accepted Dec 12, 2006.

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