Title | Cranial Ultrasound and Minor Motor Abnormalities at 2 Years in Extremely Low Gestational Age Infants. |
Publication Type | Journal Article |
Year of Publication | 2020 |
Authors | DeMauro SB, Bann C, Flibotte J, Adams-Chapman I, Hintz SR |
Journal | J Dev Behav Pediatr |
Volume | 41 |
Issue | 4 |
Pagination | 308-315 |
Date Published | 2020 05 |
ISSN | 1536-7312 |
Abstract | OBJECTIVES: The objectives of this study are to determine whether abnormalities on neonatal cranial ultrasound (CUS) are associated with minor motor abnormalities at 2 years' corrected age (CA) and to assess functional outcomes and resource utilization among children with minor motor abnormalities. METHODS: Infants born at <27 weeks in the National Institute of Child Health and Human Development Neonatal Research Network between January 1, 2010, and December 31, 2014, who underwent neuroimaging with CUS at both <28 days and ≥28 days and were evaluated at 18 to 26 months' CA, were included. Follow-up included Bayley-3, neuromotor examination, Gross Motor Function Classification System (GMFCS) level, and parent questionnaires about special services and resource needs. Children were classified by the most severe motor abnormality at 18 to 26 months' CA as follows: none, minor, or major motor function abnormality. Minor motor abnormalities were defined as any of the following: (1) Bayley-3 motor composite, fine motor score, or gross motor score 1 to 2 SDs below the test normative means; (2) mild abnormalities of axial or extremity motor skills on standardized neuromotor examination; or (3) GMFCS level 1. RESULTS: A total of 809 (35%) of 2306 children had minor motor function abnormalities alone. This did not increase substantially with CUS findings (no intraventricular hemorrhage [IVH]: 37%, grade I IVH: 32%, grade II IVH: 38%, grade III/IV IVH: 30%, isolated ventriculomegaly: 33%, and cystic periventricular leukomalacia: 24%). The adjusted odds of minor axial and upper extremity function abnormalities and GMFCS level 1 were significantly higher in children with more severe CUS findings. Children with minor motor abnormalities had increased resource utilization and evidence of functional impairment compared with those without motor function abnormalities. CONCLUSION: Minor motor abnormalities at 2 years' CA are common and cannot be predicted by neonatal CUS abnormalities alone. Minor motor abnormalities are associated with higher resource utilization and evidence of functional impairment. These findings have important implications for early counseling and follow-up planning for extremely preterm infants. |
DOI | 10.1097/DBP.0000000000000758 |
Alternate Journal | J Dev Behav Pediatr |
PubMed ID | 31880687 |
PubMed Central ID | PMC7243172 |
Grant List | U10 HD021385 / HD / NICHD NIH HHS / United States U10 HD053124 / HD / NICHD NIH HHS / United States U10 HD053119 / HD / NICHD NIH HHS / United States U10 HD021364 / HD / NICHD NIH HHS / United States U10 HD040461 / HD / NICHD NIH HHS / United States U10 HD027871 / HD / NICHD NIH HHS / United States U10 HD068278 / HD / NICHD NIH HHS / United States U10 HD053089 / HD / NICHD NIH HHS / United States U10 HD027856 / HD / NICHD NIH HHS / United States U10 HD021373 / HD / NICHD NIH HHS / United States UL1 RR024139 / RR / NCRR NIH HHS / United States U10 HD027880 / HD / NICHD NIH HHS / United States UG1 HD068244 / HD / NICHD NIH HHS / United States U10 HD053109 / HD / NICHD NIH HHS / United States U10 HD040689 / HD / NICHD NIH HHS / United States U10 HD040492 / HD / NICHD NIH HHS / United States U10 HD027853 / HD / NICHD NIH HHS / United States U10 HD027904 / HD / NICHD NIH HHS / United States U10 HD068244 / HD / NICHD NIH HHS / United States U10 HD068263 / HD / NICHD NIH HHS / United States U10 HD068270 / HD / NICHD NIH HHS / United States U10 HD027851 / HD / NICHD NIH HHS / United States UL1 TR001117 / TR / NCATS NIH HHS / United States U10 HD068284 / HD / NICHD NIH HHS / United States U10 HD034216 / HD / NICHD NIH HHS / United States U10 HD036790 / HD / NICHD NIH HHS / United States |