Prediction of neuromotor outcome in infants born preterm at 11 years of age using volumetric neonatal magnetic resonance imaging and neurological examinations

Abstract

Aim: To study the prognostic value of volumetric brain magnetic resonance imaging (MRI) at term equivalent age (TEA) and neurological examinations at TEA and at 2 years of corrected age for long-term neuromotor outcome in infants born very preterm. Method: A total of 98 infants born very preterm were included. Structural and volumetric brain MRI and the Dubowitz neurologic examination were done at TEA. The Hammersmith Infant Neurological Examination (HINE) was performed at 2 years of corrected age. The Touwen examination was used for the assessment of minor neurological dysfunction (MND) at the age of 11 years. Results: Of all children (median birthweight 1083g [quartiles 820, 1300]; gestational age 28 5/7wks [26 4/7, 30 2/7]), 41 had simple MND, 11 had complex MND (cMND), and eight had cerebral palsy (CP). The negative and positive predictive value of structural brain MRI for cMND or CP was 88% and 50% respectively. Reduced volumes of total brain tissue, frontal lobes, basal ganglia and thalami, and cerebellum associated with cMND or CP. The results of the Dubowitz neurologic examination and the HINE correlated with the Touwen examination. Interpretation: Structural and volumetric MRI at TEA and structured neurological examinations predict long-term neuromotor outcome in infants born preterm.