| Prediction of neurosensory disability in very low birth weight preterm infants. Structural and functional brain imaging and hearing screening at term age and follow-up of infants to a corrected age of 18 months | ||
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Neurological and developmental follow-up examinations and recordings of hearing ability were performed on 49 out of the 51 preterm infants at a mean (SD) corrected age of 18.6 (1.0) months in order to assess the prediction of neurosensory outcome. One infant had moved away from the district, but the infant was not excluded and some data was extracted from the patient records for evaluation. Another died of a severe chronic lung disease with complications at the corrected age of 9 months.
CP was observed in 12 out of the 51 preterm infants (24%), and in 11 out of the 48 consecutive ones (23%). There were ten infants with CP among the 35 AGA infants and two among the 16 SGA infants. Eight of the 12 infants with CP had diplegia (six spastic, one dystonic and one athetotic), while three had tetraplegia (two spastic and one dystonic), and one had spastic hemiplegia. Five infants had severe CP, three moderate CP and four mild CP. The gestational age of the infants with later CP at birth was less than 29 weeks, the mean (SD) value being 27.2 (1.4) weeks. This was significantly less than the mean of 29.9 (1.9) weeks recorded for the infants with a normal motor outcome (p<0.01, independent samples t test). Likewise, the mean (SD) birth weight of 965 (219) g for the infants with CP was significantly lower than that of 1210 (283) g for the infants without CP. A half of the CP cases were ELBW infants. None of the full-term infants had developed severe neuromotor disabilities.
The mean (SD) GQ at the corrected age of 18 months for the 49 preterm infants tested by means of Griffiths’ developmental scales was 103 (22). Five infants with a GQ less than 80 had CP, and the infants with and without CP had a mean (SD) GQ of 73 (27) and 112 (9), respectively.
Six out of the 51 infants had a SQ for hearing and speech of less than 80, their mean (SD) SQ value at a corrected age of 6 months being 59 (27). Four of these infants had hearing loss, and the other two had CP. Two of the infants with hearing loss did not attend for the developmental scoring at the corrected age of 18 months, but the remaining four received a mean (SD) SQ of 54 (28). The infants without profound hearing loss had a mean (SD) SQ of 112 (18) at a corrected age of 6 months and 109 (17) at 18 months.