title: Predicting developmental outcomes in premature infants by term equivalent MRI: systematic review and meta-analysis.
abstract: BACKGROUND
  This study aims to determine the prognostic accuracy of term MRI in very preterm born (≤32 weeks) or low-birth-weight (≤1500 g) infants for long-term (>18 months) developmental outcomes.
  
  
  METHODS
  We performed a systematic review searching Central, Medline, Embase, and PsycInfo. Two independent reviewers performed study selection, data extraction, and quality assessment. We documented sensitivity and specificity for three different MRI findings (white matter abnormalities (WMA), brain abnormality (BA), and diffuse excessive high signal intensity (DEHSI)), related to developmental outcomes including cerebral palsy (CP), visual and/or hearing problems, motor, neurocognitive, and behavioral function. Using bivariate meta-analysis, we estimated pooled sensitivity and specificity and plotted summary receiver operating characteristic (sROC) curves for different cut-offs of MRI.
  
  
  RESULTS
  We included 20 papers published between 2000 and 2013. Quality of included studies varied. Pooled sensitivity and specificity values (95 % confidence interval (CI)) for prediction of CP combining the three different MRI findings (using normal/mild vs. moderate/severe cut-off) were 77 % (53 to 91 %) and 79 % (51 to 93 %), respectively. For prediction of motor function, the values were 72 % (52 to 86 %) and 62 % (29 to 87 %), respectively. Prognostic accuracy for visual and/or hearing problems, neurocognitive, and/or behavioral function was poor. sROC curves of the individual MRI findings showed that presence of WMA provided the best prognostic accuracy whereas DEHSI did not show any potential prognostic accuracy.
  
  
  CONCLUSIONS
  This study shows that presence of moderate/severe WMA on MRI around term equivalent age can predict CP and motor function in very preterm or low-birth-weight infants with moderate sensitivity and specificity. Its ability to predict other long-term outcomes such as neurocognitive and behavioral impairments is limited. Also, other white matter related tests as BA and DEHSI demonstrated limited prognostic value.
  
  
  BACKGROUND
  PROSPERO CRD42013006362.
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. j.vanthooft@gmail.com.
authors.forename: Janneke
authors.initials: J
authors.lastname: Van't Hooft
authors.affiliation: Pediatric Clinical Research Office, Emma Children's Hospital, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. j.h.vanderlee@amc.uva.nl.
authors.forename: Johanna H
authors.initials: JH
authors.lastname: van der Lee
authors.affiliation: Clinical Research Unit, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. b.c.opmeer@amc.uva.nl.
authors.forename: Brent C
authors.initials: BC
authors.lastname: Opmeer
authors.affiliation: Pediatric Psychosocial Department, Emma Children's Hospital, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. c.aarnoudse-moens@amc.uva.nl.
authors.forename: Cornelieke S H
authors.initials: CS
authors.lastname: Aarnoudse-Moens
authors.affiliation: Medical Library, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. a.g.leenders@amc.uva.nl.
authors.forename: Arnold G E
authors.initials: AG
authors.lastname: Leenders
authors.affiliation: Robinson Research Institute, School of Pediatrics and Reproductive Health, University of Adelaide, Adelaide, 5000, SA, Australia. b.w.mol@amc.uva.nl.
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
authors.affiliation: Department of Neonatology (H3-147), Emma Children's Hospital, Academical Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. t.r.dehaan@amc.uva.nl.
authors.forename: Timo R
authors.initials: TR
authors.lastname: de Haan
mesh_terms: D001921:Brain / Q000473:pathology*; D002658:Developmental Disabilities / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008279:Magnetic Resonance Imaging; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity