Predictors of long-term outcome in very preterm infants: gestational age versus neonatal cranial ultrasound.
OBJECTIVE
To investigate the effect of gestational age at birth on the frequency of ultrasound-detected brain lesions in infants born at <33 weeks of gestation and to investigate whether the relationship between neonatal cranial ultrasound diagnosis and neurodevelopmental outcome at 8 years of age was independent of gestational age.


METHODS
Eight hundred forty-seven infants born at <33 weeks of gestation, admitted to a single tertiary referral center between 1983 and 1988, underwent serial neonatal cranial ultrasound. At 8 years of age neurodevelopmental outcome was assessed by structured neurologic examination, psychometric tests (Wechsler Intelligence Scale for Children), tests of visuomotor integration (Beery) and motor impairment (Henderson-Stott). Infants were subdivided into a group born at <28 weeks and a group born at between 28 and 32 weeks. Neurodevelopmental outcome was analyzed for each ultrasound diagnosis.


RESULTS
Hemorrhagic lesions such as germinal matrix/intraventricular hemorrhage and hemorrhagic parenchymal infarction were more frequent in infants born at <28 weeks. There was no difference in the frequency of cystic periventricular leucomalacia between the 2 groups. When neurodevelopmental outcome for each ultrasound diagnosis was compared, no significant difference was found between the 2 gestational age groups.


CONCLUSIONS
In the gestational age range studied, adverse neurodevelopmental outcome depends primarily on the type of the intracranial lesion rather than on gestational age.
Vollmer
Brigitte
B
Department of Pediatrics, University College London Medical School, Bloomsbury Campus, London, United Kingdom. b.vollmer@ich.ucl.ac.uk
Roth
Simon
S
Baudin
Jenny
J
Stewart
Ann L
AL
Neville
Brian G R
BG
Wyatt
John S
JS
D001925:Brain Damage, Chronic / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D002544:Cerebral Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D002648:Child; D002658:Developmental Disabilities / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D004453:Echoencephalography; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D011597:Psychomotor Performance