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May 1993, Vol 147, No. 5 >
Article | May 1993

Developmental Outcome of Preterm Infants With Transient Neuromotor Abnormalities FREE

Diane B. D'Eugenio, MA, OTR; Terri A. Slagle, MD; Barbara B. Mettelman, MA; StevenJ. Gross, MD
[+] Author Affiliations

Accepted for publication November 20, 1992.

Presented in part at The Society for Pediatric Research, Washington, DC, May 4, 1989.

Reprint requests to Department of Pediatrics, State University of New York Health Science Center, 750 E Adams St, Syracuse, NY 13210 (Dr Gross).


Am J Dis Child. 1993;147(5):570-574. doi:10.1001/archpedi.1993.02160290076030.
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• 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.(AJDC. 1993;147:570-574)

REFERENCES

1 +
Drillien CM.  Abnormal neurologic signs in the first year of life in low birthweight infants: possible prognostic significance . Dev Med Child Neurol . 1972;;14:575-584.
2 +
Tudehope DI, Burns YR, O'Callaghan M, Mohay H.  Minor neurological abnormalities during the first year of life in infants of birth weight <1500 g . Aust Paediatr J . 1981;;17:265-268.
3 +
Hack M, Caron B, Rivers A, Fararoff AA.  The very low birth weight infant: the broader spectrum of morbidity during infancy and early childhood . J Dev Behav Pediatr . 1983;;4:243-249.
4 +
Calame A, Reymond-Goni I, Maherzi M, Roulet M, Marchand C, Prod'hom LS.  Psychological and neurodevelopmental outcome of high risk newborn infants . Helv Paediatr Acta . 1976;;31:287-297.
5 +
Stewart K, DeitzJ, Crowe T, Robinson N, Bennett F.  Transient neurologic signs in infancy and motor outcomes at 4½ years in children born biologically at risk . Top Early Child Spec Educ . 1988;;7:71-83.
6 +
Li A, Sauve R, Creighton D.  Early indicators of learning problems in high-risk children .J Dev Behav Pediatr . 1990;;11:1-6.
7 +
Dubowitz MS, Dubowitz V, Goldberg C.  Clinical assessment of gestational age in the newborn infant . J Pediatr . 1970;;77:1-10.
8 +
Slage TA, Oliphant M, Gross SJ.  Cingulate sulcus development in the preterm infant . Pediatr Res . 1989;;26:598-602.
9 +
Ellison P, Horn J, Browning C.  Construction of an infant neurological international battery (Infanib) for the assessment of neurological integrity in infancy . Phys Ther . 1985;;76:1326-1331.
10 +
Ellison P.  Scoring sheet for the infant neurological international battery (INFANIB) . Phys Ther . 1986;;66:548-550.
11 +
Bayley N. Bayley Scales of Infant Development . New York, NY: Psychological Corp; 1969;.
12 +
McCarthy D. The McCarthy Scales of Children's Abilities . New York, NY: Psychological Corp; 1972;.
13 +
Solomons G, Holden RH, Denhoff E.  The changing picture of cerebral dysfunction in early childhood . J Pediatr . 1963;;63:113-120.
14 +
Nelson KB, Ellenberg JH.  Children who outgrow cerebral palsy . Pediatrics . 1982;;69:529-535.
15 +
Drillien CM, Thomson AJM, Burgoyne K.  Low-birthweight children at early school-age: a longitudinal study . Dev Med Child Neurol . 1980;;22:29-47.
16 +
Rubin R, Barlow B.  Infant neurological abnormalities as indicators of cognitive impairment . Dev Med Child Neurol . 1980;;22:336-343.
17 +
Ellison P, Prasse D, SiewartJ, Browning C.  Correlation of neurologic assessment in infancy with fine motor, gross motor and intellectual assessment at four years in a neonatal intensive care population . In: Stern L, Bard H, Friss-Hansen B, eds. Intensive Care of the Newborn . New York, NY: Masson Publishing USA Inc; 1983;;4:241-246.

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References

1 +
Drillien CM.  Abnormal neurologic signs in the first year of life in low birthweight infants: possible prognostic significance . Dev Med Child Neurol . 1972;;14:575-584.
2 +
Tudehope DI, Burns YR, O'Callaghan M, Mohay H.  Minor neurological abnormalities during the first year of life in infants of birth weight <1500 g . Aust Paediatr J . 1981;;17:265-268.
3 +
Hack M, Caron B, Rivers A, Fararoff AA.  The very low birth weight infant: the broader spectrum of morbidity during infancy and early childhood . J Dev Behav Pediatr . 1983;;4:243-249.
4 +
Calame A, Reymond-Goni I, Maherzi M, Roulet M, Marchand C, Prod'hom LS.  Psychological and neurodevelopmental outcome of high risk newborn infants . Helv Paediatr Acta . 1976;;31:287-297.
5 +
Stewart K, DeitzJ, Crowe T, Robinson N, Bennett F.  Transient neurologic signs in infancy and motor outcomes at 4½ years in children born biologically at risk . Top Early Child Spec Educ . 1988;;7:71-83.
6 +
Li A, Sauve R, Creighton D.  Early indicators of learning problems in high-risk children .J Dev Behav Pediatr . 1990;;11:1-6.
7 +
Dubowitz MS, Dubowitz V, Goldberg C.  Clinical assessment of gestational age in the newborn infant . J Pediatr . 1970;;77:1-10.
8 +
Slage TA, Oliphant M, Gross SJ.  Cingulate sulcus development in the preterm infant . Pediatr Res . 1989;;26:598-602.
9 +
Ellison P, Horn J, Browning C.  Construction of an infant neurological international battery (Infanib) for the assessment of neurological integrity in infancy . Phys Ther . 1985;;76:1326-1331.
10 +
Ellison P.  Scoring sheet for the infant neurological international battery (INFANIB) . Phys Ther . 1986;;66:548-550.
11 +
Bayley N. Bayley Scales of Infant Development . New York, NY: Psychological Corp; 1969;.
12 +
McCarthy D. The McCarthy Scales of Children's Abilities . New York, NY: Psychological Corp; 1972;.
13 +
Solomons G, Holden RH, Denhoff E.  The changing picture of cerebral dysfunction in early childhood . J Pediatr . 1963;;63:113-120.
14 +
Nelson KB, Ellenberg JH.  Children who outgrow cerebral palsy . Pediatrics . 1982;;69:529-535.
15 +
Drillien CM, Thomson AJM, Burgoyne K.  Low-birthweight children at early school-age: a longitudinal study . Dev Med Child Neurol . 1980;;22:29-47.
16 +
Rubin R, Barlow B.  Infant neurological abnormalities as indicators of cognitive impairment . Dev Med Child Neurol . 1980;;22:336-343.
17 +
Ellison P, Prasse D, SiewartJ, Browning C.  Correlation of neurologic assessment in infancy with fine motor, gross motor and intellectual assessment at four years in a neonatal intensive care population . In: Stern L, Bard H, Friss-Hansen B, eds. Intensive Care of the Newborn . New York, NY: Masson Publishing USA Inc; 1983;;4:241-246.

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