Preterm Neuroimaging and School-Age Cognitive Outcomes.
BACKGROUND AND OBJECTIVES: Children born extremely preterm are at risk for cognitive difficulties and disability. The relative prognostic value of neonatal brain MRI and cranial ultrasound (CUS) for school-age outcomes remains unclear. Our objectives were to relate near-term conventional brain MRI and early and late CUS to cognitive impairment and disability at 6 to 7 years among children born extremely preterm and assess prognostic value.
METHODS: A prospective study of adverse early and late CUS and near-term conventional MRI findings to predict outcomes at 6 to 7 years including a full-scale IQ (FSIQ)(FSIQ
RESULTS: A total of 386 children had follow-up. In unadjusted analyses, severity of white matter abnormality and cerebellar lesions on MRI and adverse CUS findings were associated with outcomes. In full regression models, both adverse late CUS findings (odds ratio [OR] 27.9; 95% confidence interval [CI] 6.0-129) and significant cerebellar lesions on MRI (OR 2.71; 95% CI 1.1-6.7) remained associated with disability, but only adverse late CUS findings (OR 20.1; 95% CI 3.6-111) were associated with FSIQ
CONCLUSIONS: Severe but rare adverse late CUS findings were most strongly associated with cognitive impairment and disability at school age, and significant cerebellar lesions on MRI were associated with disability. Near-term conventional MRI did not substantively enhance prediction of severe early school-age outcomes.
American Academy of Pediatrics
Hintz, Susan R; Betty R Vohr; Carla M Bann; H Gerry Taylor; Abhik Das; Kathryn E Gustafson; Kimberly Yolton; Victoria E Watson; Jean Lowe; Maria Elena DeAnda; M Bethany Ball; Neil N Finer; Krisa P Van Meurs; Seetha Shankaran; Athina Pappas; Patrick D Barnes; Dorothy Bulas; Jamie E Newman; Deanne E Wilson-Costello; Roy J Heyne; Heidi M Harmon; Myriam Peralta-Carcelen; Ira Adams-Chapman; Andrea Freeman Duncan; Janell Fuller; Yvonne E Vaucher; Tarah T Colaizy; Sarah Winter; Elisabeth C McGowan; Ricki F Goldstein; and Rosemary D Higgins.
"Preterm Neuroimaging and School-Age Cognitive Outcomes.."