Short and long term prognostic significance of neurological anomalies of the first year in very low birthweight infants.
The short and long term, prognostic significance of early neuromotor anomalies was assessed in infants with birthweight under 1500 g (VLBW infants), who have a high risk of developing cerebral palsy (CP) but who also have transient neurological anomalies. The series comprises 35 VLBW infants born between 1 January 1978 and 31 March 1980 with regular neurological follow-up until the second year of life: 10 with CP of varying severity and 25 without CP. The latter were examined in the first year of school by means of an age-specific method designed to elicit minor neurological dysfunctions (MND). Analysis of neuromotor development in the first year of life identified important grounds for clinical suspicion in the first semester of corrected age, especially on the basis of a global neurological assessment including optimal neurological items score at presumed term age and the combination of two or more major neurological signs in the first semester. The diagnosis of CP cannot be established until the 2nd semester of life, in 70% of cases by the end of the 3rd trimester. It rests on the following criteria: persistence of two or more major neurological signs (abnormalities of limb tone, axial tone and of movement), specific pathological pattern of limb tone, always associated with retarded postural control. Neurological examination at school age revealed a significantly higher frequency of MND in the VLBW children than in a group of normal controls. The quantity of MND correlated significantly with the severity and duration of the first year neurological anomalies but not with the obstetric and postnatal neurological risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)
D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis; D002547:Cerebral Palsy / Q000175:diagnosis; D002658:Developmental Disabilities / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis*; D011379:Prognosis