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Developmental outcome of preterm infants with transient neuromotor abnormalities
D B D'Eugenío1, T A Slagle, B B Mettelman
1Department of Pediatrics, State University of New York Health Science Center, Syracuse 13210.
Insights
Transient early neurologic abnormalities in preterm infants do not predict later cognitive delays. This study found similar cognitive outcomes at age 4, regardless of temporary early neurological findings.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Cognitive neuroscience
Background:
- Preterm infants are at increased risk for neurodevelopmental abnormalities.
- Early identification of neurologic findings is crucial for timely intervention.
- The long-term cognitive impact of transient neurologic abnormalities in this population requires further investigation.
Purpose of the Study:
- To examine the relationship between transiently abnormal neurologic findings in preterm infants and their cognitive outcomes at 4 years of age.
Main Methods:
- Prospective follow-up study of 131 preterm infants (gestational age ≤32 weeks).
- Neuromotor evaluations at 6 and 15 months to identify transiently abnormal and normal groups.
- Cognitive assessments at 4 years using the McCarthy Scales.
Main Results:
- Infants with transiently abnormal neurologic findings showed poorer cognitive scores at 6, 15, and 24 months.
- However, at 4 years, cognitive performance was similar between the transiently abnormal and normal groups.
- The incidence of poor cognitive outcome decreased significantly by age 4 in the transiently abnormal group.
Conclusions:
- Transient early neurologic abnormalities in preterm infants do not appear to be predictive of cognitive delays at 4 years of age.
- Cognitive development may show catch-up in preterm infants with initially transient neurologic issues.
Objective:
To determine the relationship between transiently abnormal neurologic findings in preterm infants and subsequent cognitive outcome at 4 years of age.
Design:
Prospective 4-year follow-up.
Setting:
Regional perinatal center in Syracuse, NY.
Participants:
One hundred thirty-one of 135 consecutively born infants of no more than 32 weeks of gestational age; 98% followed up from birth to 4 years of age.
Interventions:
None.
Measurements And Main Results:
Based on neuromotor evaluations performed at 6 and 15 months of age, two groups of infants were identified. One group had abnormal neurologic findings at 6 months of age that had resolved by 15 months of age (transiently abnormal group). The other group had normal neuromotor findings at both 6 and 15 months of age (normal group). The transiently abnormal group had significantly poorer scores on the Bayley Mental scale at 6 months of age (90 +/- 15 vs 108 +/- 10; P < .001), 15 months (91 +/- 21 vs 105 +/- 12; P < .001), and 24 months (91 +/- 19 vs 101 +/- 17; P < .001). However, at 4 years of age, cognitive performance on the McCarthy Scales was similar for the transiently abnormal and normal groups (General Cognitive index, 93 +/- 13 and 95 +/- 14, respectively). The incidence of poor cognitive outcome (Cognitive index < 84) decreased from 39% at 2 years of age to 18% at 4 years of age in the group with a history of transient neurologic abnormalities but remained unchanged (16% to 18%) in the normal group.
Conclusion:
Early neurologic abnormalities that are transient did not predict cognitive delays at 4 years of age in preterm infants.