Predicting neurodevelopmental impairment in preterm infants by standardized neurological assessments at 6 and 12 months corrected age.
OBJECTIVE
Neurodevelopmental impairment in very preterm infants can be reasonably diagnosed by 18-24 months corrected age, whereas the predictive value of earlier assessments is debated. We hypothesized that neurological findings at 6 and 12 months indicative of subsequent cerebral palsy predict 18-24 months' neurodevelopmental impairment.


METHODS
Neurodevelopmental examinations (Griffiths scales) at 20 months of age in 561 preterm infants (birth weight <1 500 g) were compared with results of standardized neurological examinations (Early Motor Pattern Profile; EMPP) and Griffiths scales at 6 (n = 451) and 12 months (n = 496) corrected age.


RESULTS
Griffiths developmental quotients at 20 months were weakly but significantly related to EMPP scores at 6 (R(s) = 0.328) and 12 months (R(s) = 0.493). Areas under receiver operator characteristic curves for the EMPP to predict neurodevelopmental impairment (Griffiths scores <or=75) at 20 months were 0.772 (0.890) at 6 (12) months, compared to 0.915 (0.962) for Griffiths scores. By contrast, EMPP and Griffiths scores had equal power to predict unability to walk unaided at 2 years of age (EMPP 6/12 months: 0.946/0.983; Griffiths 6/12 months: 0.935/0.985).


CONCLUSIONS
Neurological examinations with the EMPP at 6 and 12 months corrected age are of limited value to predict neurodevelopmental impairment at 20 months.
Grimmer
I
I
Department of Neonatology and Social Pediatrics, Charité University Medical Center, Berlin, Germany.
Metze
B C
BC
Walch
E
E
Scholz
T
T
Bührer
C
C
D002547:Cerebral Palsy / Q000175:diagnosis*; D002658:Developmental Disabilities / Q000175:diagnosis*; D042241:Early Diagnosis; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D009043:Motor Activity / Q000502:physiology; D019957:Motor Skills Disorders / Q000175:diagnosis*; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D012372:ROC Curve