[Prognostic value of the neurodevelopmental status in the first year of life in children with increased perinatal risk].
Among 503 high-risk newborns followed-up systematically in a prospective study up to 5 years of age, abnormalities of the development of posture, of maturation of tone and of psychomotor development were diagnosed at the age of 6 months in 70 children (13.9%) who form the study group. Among the other 433 high-risk newborns who presented a normal psychomotor development at the age of 6 months, 73 were selected at random and form the control group. In the study group, 59% of the children had a development which became normal during the second year of life (transitory disorders), 21% had persistent minor neurological abnormalities at the age of 5 years, and 20% evolved towards cerebral palsy and/or mental retardation. In the control group, 97.3% of the children remained normal and 2.7% presented minor neurological abnormalities at 5 years. Three parameters are important to estimate the prognosis of the children in the study group. These are: the presence of neurological disorders during the neonatal period, the type of neurodevelopmental abnormalities diagnosed at the age of 6 months, and the evolution of these abnormalities during the second semester of life. Among the 14 major handicaps, 13 were found in children who presented neurological neonatal disorders and 12 appeared in children who had an abnormality of muscular tonus associated with cognitive and social retardation at the age of 6 months. 52% of the children, whose status had not been "normalized" at 12 months, had a major handicap at 5 years. However, a hypertonia predominating in the lower limbs and observed at 6 months has a good prognosis; it disappears during the second year of life in 81.2% of cases (transitory disorders) and is associated with persistent minor neurological abnormalities in 18.8% of cases.--This study gives useful information for the establishment of an early prognosis and a rational management of the high-risk newborn children who present neurodevelopmental abnormalities during their first year of life.
D002547:Cerebral Palsy / Q000523:psychology; D002657:Child Development; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000523:psychology; D009129:Muscle Tonus; D011379:Prognosis; D011446:Prospective Studies; D011596:Psychomotor Disorders / Q000523:psychology; D011597:Psychomotor Performance; D012306:Risk
Valeur pronostique du status neuro-développemental durant la première année de vie chez les enfants à risque périnatal élevé.