title: Neonatal neurological examination as a predictor of neuromotor outcome at 4 months in term low-Apgar-score babies in Zimbabwe.
abstract: The predictive value of the neonatal neurological examination (NNE) adapted from Prechtl, was investigated in 139 term Zimbabwean infants born with an Apgar score of five or less at 5 min. At 4 months, seven infants had died and 13 were lost to follow-up, leaving 119 infants to undergo the Infant Motor Screen (IMS). Eighty-eight infants were diagnosed as normal, six as suspect and 25 as abnormal at screening. The sensitivity, specificity, positive predictive value and negative predictive value of the NNE were 94%, 55%, 42% and 96%, respectively. Seventeen (14%) infants had developed microcephaly at 4 months and 13 (77%) of them scored abnormal on the IMS. Twenty-three of the 48 (48%) infants who had convulsions within 48 h of birth, were diagnosed as abnormal (P < 0.0001). The NNE proved to be very sensitive in detecting neurodevelopmental abnormalities in the neonatal period and the five abnormal syndromes derived from the NNE were able to correctly identify 94% of the abnormal infants.
authors.affiliation: Children's Rehabilitation Unit, Mpilo Central Hospital, Bulawayo, Zimbabwe.
authors.forename: M J
authors.initials: MJ
authors.lastname: Wolf
authors.forename: G
authors.initials: G
authors.lastname: Beunen
authors.forename: P
authors.initials: P
authors.lastname: Casaer
authors.forename: B
authors.initials: B
authors.lastname: Wolf
mesh_terms: D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D008831:Microcephaly / Q000175:diagnosis; D009048:Motor Skills; D009422:Nervous System Diseases / Q000175:diagnosis*; D009460:Neurologic Examination; D012640:Seizures / Q000175:diagnosis; D012680:Sensitivity and Specificity; D015030:Zimbabwe