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ORIGINAL ARTICLE
Year : 2021  |  Volume : 10  |  Issue : 3  |  Page : 182-186

A standardized approach to routine cranial ultrasonography in preterm infants: Improved neuromotor outcome predictability at 2 years and communication with parents


1 Department of Obstetrics, Sheffield Teaching Hospitals, Sheffield, England
2 Department of Neonatal Medicine, The James Cook University Hospital, Middlesbrough, England

Correspondence Address:
Shalabh Garg
Department of Neonatal Medicine, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW
England
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcn.jcn_192_20

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Aim: The aim of this study is to evaluate the predictive value of routine cranial ultrasonography in preterm infants under 32 weeks' gestation with their neuromotor outcome at 2 years. Methods: This was a prospective, single-center, cohort study of preterm infants under 32 weeks' gestation. Each infant had an early (within 1 week of birth) and late (at 6 weeks postnatal age) cranial ultrasound scan performed. Each infant's scan result was independently assessed for the presence of major cranial abnormalities, such as intraventricular hemorrhage Grade 3 or 4, cystic periventricular leukomalacia, and porencephalic cyst. All surviving infants who returned for follow-up at 2 years' corrected age had their neuromotor development assessed using the Bayley Scales of Infant Development. The predictive value of major cranial abnormalities for the neuromotor delay was derived. Results: A total of 134 infants were included over 2 year. Of the 89 children with no major abnormality, 78 did not have a significant neuromotor delay, giving a negative predictive value of 87.6%. Of the six children with major abnormalities, two had a significant neuromotor delay, giving a positive predictive value of 33.3%. Conclusions: The absence of a major abnormality on quality-controlled routine cranial ultrasound scan in preterm infants under 32 weeks' gestation appears to be a good predictor of no significant abnormality in neuromotor development at 2 years of age.


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