PROBABILITÉ OF NEURODEVELOPMENTAL DISORDERS ESTIMATED FROM ULTRASOUND APPEARANCE OF BRAINS OF VERY PRETERM INFANTS

The neurodevelopmental status of 342 very preterm infants who had undergone prospective ultrasound brainscans was assessed at a median corrected age of 52 weeks. The probabilities for neurodevelopmental disorders were calculated according to the ultrasound findings. The results showed that the probabilité of a major or minor disorder was low for infants whose scans did not show periventricular haemorrhage or markedly increased parenchymal echodensities in the first week of life, and for those whose scans at discharge gave no evidence of ventricular dilatation, hydrocephalus or cerebral atrophy. By contrast, the probabilité of a disorder was very high for infants with markedly increased parenchymal echodensities in the first week, and for infants with evidence of cerebral atrophy at discharge. The majority of the infants could be assigned, on the basis of the ultrasound scan at discharge, either to a large group who were at low risk of neurodevelopmental disorders or to a small group who were at high risk; the remainder were at intermediate risk. These findings may be used as a guide to the prognosis for other infants whose ultrasound scans show similar appearances.

[1]  A. Orgill,et al.  Effect of neonatal periventricular haemorrhage on neurodevelopmental outcome. , 1985, Archives of disease in childhood.

[2]  L. Becker,et al.  Periventricular infarction diagnosed by ultrasound: a postmortem correlation. , 1984, The Journal of pediatrics.

[3]  E. Reynolds,et al.  PREDICTION OF DEATH AND MAJOR HANDICAP IN VERY PRETERM INFANTS BY BRAIN ULTRASOUND , 1981, The Lancet.

[4]  J. Wyatt,et al.  INCREASED PERIVENTRICULAR ECHCDENSITIES IN VERY PRETERM INFANTS AND PREDICTION OF EARLY NEURCDEVELOPMENTAL OUTCOME , 1985, Pediatric Research.

[5]  D. Rushton,et al.  Structure and evolution of echo dense lesions in the neonatal brain. A combined ultrasound and necropsy study. , 1985, Archives of disease in childhood.

[6]  S. Sinha,et al.  RELATION BETWEEN PERIVENTRICULAR HAEMORRHAGE AND ISCHAEMIC BRAIN LESIONS DIAGNOSED BY ULTRASOUND IN VERY PRE-TERM INFANTS , 1985, The Lancet.

[7]  F. Battaglia.  Intrauterine growth. , 1969, The Journal of pediatrics.

[8]  S. Gould,et al.  Periventricular intraparenchymal cerebral haemorrhage in preterm infants: The role of venous infarction , 1987, The Journal of pathology.

[9]  M I Levene,et al.  Measurement of the growth of the lateral ventricles in preterm infants with real-time ultrasound. , 1981, Archives of disease in childhood.

[10]  A. Stewart.  Early prediction of neurological outcome when the very preterm infant is discharged from the intensive care unit. , 1985, Annales de pediatrie.

[11]  L. Lubchenco,et al.  INTRAUTERINE GROWTH AS ESTIMATED FROM LIVEBORN BIRTH-WEIGHT DATA AT 24 TO 42 WEEKS OF GESTATION. , 1963, Pediatrics.

[12]  L M Dubowitz,et al.  Developmental and neurological progress of preterm infants with intraventricular haemorrhage and ventricular dilatation. , 1982, Archives of disease in childhood.

[13]  G. Bydder,et al.  Developmental sequence of periventricular leukomalacia. Correlation of ultrasound, clinical, and nuclear magnetic resonance functions. , 1985, Archives of disease in childhood.

[14]  E. Reynolds,et al.  Ultrasound appearance of the brain in very preterm infants and neurodevelopmental outcome at 18 months of age. , 1983, Archives of disease in childhood.

[15]  V. Dubowitz,et al.  Hemorrhagic periventricular leukomalacia in the neonate: a real-time ultrasound study. , 1983, Pediatrics.

[16]  B. Pasamanick,et al.  A developmental screening inventory for infants. , 1966, Pediatrics.

[17]  S. Shankaran,et al.  Sonographic classification of intracranial hemorrhage. A prognostic indicator of mortality, morbidity, and short-term neurologic outcome. , 1982, The Journal of pediatrics.

[18]  R. Illingworth.  Delayed Visual Maturation , 1961, Archives of disease in childhood.

[19]  L. Dubowitz,et al.  PREDICTIVE VALUE OF CRANIAL ULTRASOUND IN THE NEWBORN BABY: A REAPPRAISAL , 1985, The Lancet.

[20]  C. Fawer,et al.  Neurodevelopmental outcome at 12 months of age related to cerebral ultrasound appearances of high risk preterm infants. , 1985, Early human development.

[21]  A. Rimm,et al.  Transplant or chemotherapy in acute myelogenous leukaemia , 1989 .

[22]  M. Thaler,et al.  REYE'S SYNDROME , 1975, The Lancet.

[23]  F. R. Zadik.  FRACTURE OF THE FEMORAL NECK. , 1964, Lancet.

[24]  E. Reynolds,et al.  Timing and antecedents of periventricular haemorrhage and of cerebral atrophy in very preterm infants. , 1982, Early human development.

[25]  T. Fok,et al.  DEVELOPMENT OF CEREBRAL PALSY AFTER ULTRASONOGRAPHIC DETECTION OF PERIVENTRICULAR CYSTS IN THE NEWBORN , 1985, Developmental medicine and child neurology.

[26]  E. Reynolds,et al.  ULTRASOUND DETECTION OF BRAIN DAMAGE IN PRETERM INFANTS , 1979, The Lancet.

[27]  J. Volpe,et al.  Outcome of neonatal intraventricular hemorrhage with periventricular echodense lesions , 1984, Annals of neurology.

[28]  E. Reynolds,et al.  OUTCOME FOR INFANTS OF VERY LOW BIRTHWEIGHT: SURVEY OF WORLD LITERATURE , 1981, The Lancet.