Value of neurosonography in predicting subsequent cognitive and motor development in extremely low birth weight neonates.
OBJECTIVE
To compare the results of neurosonography (NSG) with subsequent neurodevelopmental testing in extremely low birth weight (ELBW; < or =1000 g) neonates.


METHODS
NSG at hospital discharge was available in 164 neonates and Bayley Scores of Infant Development (BSID II) evaluations (MDI and PDI) were performed in 158 of these infants at 18 to 22 months. Neurosonographic studies obtained prior to the discharge study also were evaluated. Neurosonograms were interpreted by pediatric radiologists, and BSID II examinations were performed by certified examiners masked to the results of the neurosonographic studies.


RESULTS
A normal sonographic study at discharge was observed in 44% (14/32) of neonates with MDI <70 and 29% (7/24) with PDI <70. Furthermore, the sonographic study at discharge was normal in 59% (36/61) of neonates with MDI 70 to 84 and 56% (31/55) with PDI 70 to 84. Conversely, approximately 30 to 40% of those with an abnormality noted on neurosonogram at discharge, or at any time during hospitalization, had MDI and/or PDI scores > or =85. The association between abnormal NSG at discharge and low BSID II results was stronger for the PDI exam compared with the MDI exam.


CONCLUSIONS
These results emphasize the limitations of NSG in predicting subsequent neurodevelopmental outcome in ELBW neonates. The primary role for NSG in ELBW neonates may be in the diagnosis and management of acute problems, such as intraventricular hemorrhage and posthemorrhagic hydrocephalus, and not as a tool to predict subsequent outcome.
LeFlore
Judy L
JL
Children's Medical Center of Dallas, TX, USA.
Broyles
R Sue
RS
Pritchard
Marcia A
MA
Engle
William D
WD
D002552:Cerebral Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D002657:Child Development; D003071:Cognition; D004108:Dilatation, Pathologic; D004453:Echoencephalography; D005260:Female; D006257:Head / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007969:Leukomalacia, Periventricular / Q000000981:diagnostic imaging; D008297:Male; D011237:Predictive Value of Tests