RT Journal Article
SR Electronic
T1 Predicting Motor Development in Very Preterm Infants at 12 Months’ Corrected Age: The Role of Qualitative Magnetic Resonance Imaging and General Movements Assessments
JF Pediatrics
JO Pediatrics
FD American Academy of Pediatrics
SP 512
OP 517
DO 10.1542/peds.2008-0590
VO 123
IS 2
A1 Spittle, Alicia J.
A1 Boyd, Roslyn N.
A1 Inder, Terrie E.
A1 Doyle, Lex W.
YR 2009
UL http://pediatrics.aappublications.org/content/123/2/512.abstract
AB 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.