title: Neurological examination of preterm infants at term equivalent age.
abstract: BACKGROUND
  We previously reported the neurological findings of the Dubowitz neonatal examination in a cohort of 157 low-risk preterms born between 25 and 33 weeks gestational age (GA) and examined at term equivalent age (TEA). Median and range of scores were wider than those found in term-born infants and preterms showed a different neurological behaviour in specific items. However, the cohort number was too small to draw any definitive conclusion about the distribution of findings.
  
  
  OBJECTIVE
  We provide normative data from a low-risk cohort of 380 preterm infants; we also assess the findings and their relationship to motor outcome in preterms with major cranial ultrasound (US) abnormality.
  
  
  METHODS
  We assessed, at TEA, 380 low-risk preterms born <35 weeks gestation (range 25-34.9, median 29) with normal 2 year motor outcome and 85 preterm infants with major US abnormality.
  
  
  RESULTS
  At TEA low-risk preterms had less flexor limb tone, poorer head control but better visual following than term-born infants. For 28/34 of the neurological items the range and median scores were similar across gestational ages. In infants with major US lesions the range and median scores differed from low-risk preterms in 20/34 items; 40% of infants developing a diplegia and 80% developing a tetraplegia had >7 items outside the 90th centile; all infants with >12 items outside the 90th centile developed a tetraplegia.
  
  
  CONCLUSIONS
  We provide reference values for the neurological examination of low-risk preterms at TEA. In infants with major US abnormality the number of items outside the 90th centile was an indicator of outcome severity.
authors.affiliation: Department of Paediatrics and Imaging Sciences, Hammersmith Campus, Imperial College, London, UK. daniricciola@libero.it
authors.forename: Daniela
authors.initials: D
authors.lastname: Ricci
authors.forename: Domenico M M
authors.initials: DM
authors.lastname: Romeo
authors.forename: Leena
authors.initials: L
authors.lastname: Haataja
authors.forename: Ingrid C
authors.initials: IC
authors.lastname: van Haastert
authors.forename: Laura
authors.initials: L
authors.lastname: Cesarini
authors.forename: Jonna
authors.initials: J
authors.lastname: Maunu
authors.forename: Marika
authors.initials: M
authors.lastname: Pane
authors.forename: Francesca
authors.initials: F
authors.lastname: Gallini
authors.forename: Rita
authors.initials: R
authors.lastname: Luciano
authors.forename: Costantino
authors.initials: C
authors.lastname: Romagnoli
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.forename: Frances M
authors.initials: FM
authors.lastname: Cowan
authors.forename: Eugenio
authors.initials: E
authors.lastname: Mercuri
mesh_terms: D015331:Cohort Studies; D005865:Gestational Age; D006801:Humans; D018730:Infant Behavior / Q000502:physiology*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D009129:Muscle Tonus / Q000502:physiology; D009460:Neurologic Examination / Q000379:methods*; D011187:Posture / Q000502:physiology; D011446:Prospective Studies