Predictive values of cranial ultrasound and assessment of general movements for neurological development of preterm infants in the Maribor region of Slovenia.
OBJECTIVE
The aim of the study was to assess the predictive values of cranial ultrasound (US) scans and assessment of general movements of fidgety character (GMs) for the later neurological development of preterm infants in the Maribor region of Slovenia.


METHODS
Results of cranial US scans done longitudinally from the day of birth until the end of three months of chronologic age and results of GMs at three months of corrected age were compared with traditional neurological examination and evaluation of psychomotor development of the same children at the corrected age of six years.


RESULTS
A total of 112 preterm infants (gestational age 37 weeks and below) were included in the study. The infants were classified as low-risk or high-risk for neurological impairment on the basis of cranial US scans. The scans classified as low-risk were followed by a normal neurological outcome in 74 (89%) of 83 infants; those classified as high-risk for neurological impairment were followed by abnormal neurological outcome in 21 (72%) of 29 infants. Of 77 infants with normal fidgety movements, 73 (95%) had a normal neurological outcome and 4 (5%) had an abnormal neurological outcome; of 35 infants with abnormal or absent fidgety movements, 26 (74%) had an abnormal neurological outcome and 9 (26%) had a normal neurological outcome. Of 30 children with abnormal outcome, cerebral palsy was diagnosed in 16, mental retardation in one, nine children had both of these, and four had complex minor neurological dysfunction. The validity of the scans was 85%, sensitivity 70%, specificity 90%, positive predictive value 72% and negative predictive value 89%; the validity of the GMs was 88%, sensitivity 87%, specificity 89%, positive predictive value 74% and negative predictive value 95%.


CONCLUSIONS
The sensitivity of the cranial US scans was clearly lower than that of assessment of general movements of a fidgety character. The specificities of the two methods were almost the same.
Seme-Ciglenecki
Polona
P
Center for Children with Developmental Disabilities, Dispensary for Children, Maribor Public Health Center, Maribor, Slovenia. polona.seme@email.si
D001925:Brain Damage, Chronic / Q000000981:diagnostic imaging*; D002547:Cerebral Palsy / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D017523:Croatia; D004453:Echoencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging*; D008607:Intellectual Disability / Q000000981:diagnostic imaging*; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011596:Psychomotor Disorders / Q000000981:diagnostic imaging*; D012307:Risk Factors