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American Academy of Pediatrics
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Predicting Motor Development in Very Preterm Infants at 12 Months’ Corrected Age: The Role of Qualitative Magnetic Resonance Imaging and General Movements Assessments

Alicia J. Spittle, Roslyn N. Boyd, Terrie E. Inder and Lex W. Doyle
Pediatrics February 2009, 123 (2) 512-517; DOI: https://doi.org/10.1542/peds.2008-0590
Alicia J. Spittle
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Roslyn N. Boyd
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Terrie E. Inder
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Lex W. Doyle
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Abstract

OBJECTIVE. The objective of this study was to compare the predictive value of qualitative MRI of brain structure at term and general movements assessments at 1 and 3 months' corrected age for motor outcome at 1 year's corrected age in very preterm infants.

PATIENTS AND METHODS. Eighty-six very preterm infants (<30 weeks' gestation) underwent MRI at term-equivalent age, were evaluated for white matter abnormality, and had general movements assessed at 1 and 3 months' corrected age. Motor outcome at 1 year's corrected age was evaluated with the Alberta Infant Motor Scale, the Neuro-Sensory Motor Development Assessment, and the diagnosis of cerebral palsy by the child's pediatrician.

RESULTS. At 1 year of age, the Alberta Infant Motor Scale categorized 30 (35%) infants as suspicious/abnormal; the Neuro-Sensory Motor Development Assessment categorized 16 (18%) infants with mild-to-severe motor dysfunction, and 5 (6%) infants were classified with cerebral palsy. White matter abnormality at term and general movements at 1 and 3 months significantly correlated with Alberta Infant Motor Scale and Neuro-Sensory Motor Development Assessment scores at 1 year. White matter abnormality and general movements at 3 months were the only assessments that correlated with cerebral palsy. All assessments had 100% sensitivity in predicting cerebral palsy. White matter abnormality demonstrated the greatest accuracy in predicting combined motor outcomes, with excellent levels of specificity (>90%); however, the sensitivity was low. On the other hand, general movements assessments at 1 month had the highest sensitivity (>80%); however, the overall accuracy was relatively low.

CONCLUSION. Neuroimaging (MRI) and functional (general movements) examinations have important complementary roles in predicting motor development of very preterm infants.

  • cerebral palsy
  • motor development
  • MRI
  • neonatal
  • premature infants
  • Accepted May 5, 2008.
  • Copyright © 2009 by the American Academy of Pediatrics

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Pediatrics
Vol. 123, Issue 2
February 2009
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Predicting Motor Development in Very Preterm Infants at 12 Months’ Corrected Age: The Role of Qualitative Magnetic Resonance Imaging and General Movements Assessments
Alicia J. Spittle, Roslyn N. Boyd, Terrie E. Inder, Lex W. Doyle
Pediatrics Feb 2009, 123 (2) 512-517; DOI: 10.1542/peds.2008-0590

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Predicting Motor Development in Very Preterm Infants at 12 Months’ Corrected Age: The Role of Qualitative Magnetic Resonance Imaging and General Movements Assessments
Alicia J. Spittle, Roslyn N. Boyd, Terrie E. Inder, Lex W. Doyle
Pediatrics Feb 2009, 123 (2) 512-517; DOI: 10.1542/peds.2008-0590
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