[The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants].
OBJECTIVE
To verify the predictive value of two tests (neurological assessment and ultrasonography) performed at the time of discharge, with respect to the neuromotor and cognitive development of premature infants.


METHODS
Seventy very low birth weight premature infants (below 1,500 g), admitted to the Neonatal Department between 1992 and 1994 were studied. The average birth weight and gestation age were, respectively, 1,185 g (SD: 180 g) and 32.2 weeks (SD: 1.4). At the term correct age, neurological assessment by the Dubowitz & Dubowitz method and cerebral ultrasonography were carried out. After discharge, the development was monitored at the follow up clinic.


RESULTS
At 21 months correct age (SD: 4.9), neuromotor and cognitive abnormalities were observed, respectively, in 25.7% and 20.3% of the infants evaluated. The neonatal neurological assessment was found to be more sensitive than those specific for neuromotor (sensibility: 77.7%, specificity: 57.6%) and cognitive (sensibility: 78.5%, specificity: 56.4%) abnormalities, and exhibited low predictive value for both neuromotor and cognitive abnormality. Ultrasonography exhibited high specificity with respect to both neuromotor and cognitive development. The cerebral ultrasonography has also a reasonable predictive value for neuromotor abnormality.


CONCLUSIONS
The combination of both tests yielded higher predictive values.
Departamento de Neonatologia do Instituto Fernandes Figueira da Fundação Oswaldo Cruz (IFF/FIOCRUZ), Rio de Janeiro, Brasil. rosanemello@openlink.com.br
R R
RR
Mello
M V
MV
Dutra
K S
KS
Silva
J M
JM
Lopes
D001921:Brain; D002675:Child, Preschool; D004453:Echoencephalography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D008297:Male; D009043:Motor Activity; D019954:Neurobehavioral Manifestations; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity