Related Experiment Video
Updated: Apr 11, 2026
07:36
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
12.0K
Early school outcomes for extremely preterm infants with transient neurological abnormalities
Heidi M Harmon1, H Gerry Taylor1, Nori Minich1
1Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.
Developmental Medicine and Child Neurology
|May 28, 2015
Summary
Transient neurological abnormalities (TNA) in extremely preterm infants at 9 months predict lower cognitive and academic skills by age 6, even with later normal assessments. This highlights risks for preterm children.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Neurodevelopmental outcomes
Background:
- Extremely preterm infants are at high risk for neurodevelopmental deficits.
- Transient neurological abnormalities (TNA) are common in this population.
- Predictive value of early neurological assessments for long-term outcomes requires further investigation.
Purpose of the Study:
- To determine if transient neurological abnormalities (TNA) identified at 9 months corrected age predict cognitive, behavioral, and motor outcomes at 6 years of age in extremely preterm infants.
- To assess the long-term impact of early neurological status on school-age functioning.
Main Methods:
- A cohort of 124 extremely preterm infants (gestational age 25.5 weeks) were assessed using the Amiel-Tison Neurological Assessment at 9 and 20 months corrected age.
- Infants were classified into groups: TNA (n=17), normal neurological assessment (n=89), or neurologically abnormal assessment (n=18).
- Children underwent comprehensive assessments of cognition, academic achievement, motor ability, and behavior at approximately 6 years of age.
Main Results:
- Children with a history of TNA showed significantly lower adjusted mean scores in spatial relations, visual matching, letter-word identification, and spelling compared to those with normal neurological assessments.
- Higher postnatal steroid exposure was observed in the TNA group (35% vs 9%).
- Cognitive and academic deficits were evident despite normalized neurological assessments by 20 months in the TNA group.
Conclusions:
- Extremely preterm children with a history of transient neurological abnormalities (TNA) are at increased risk for poorer cognitive and academic outcomes in early school years.
- Even with a normalized neurological assessment by 20 months corrected age, a history of TNA indicates a persistent vulnerability.
- These findings underscore the importance of continued monitoring and support for extremely preterm infants, particularly those with early neurological disturbances.
