Universidad Peruana Cayetano Heredia

Combined predictors of neurodevelopment in very low birth weight preterm infants

Combined predictors of neurodevelopment in very low birth weight preterm infants

Medina-Alva, Pilar; Duque, Kevin R.; Zea-Vera, Alonso; Bellomo, Sicilia; Cárcamo Cavagnaro, César Paul Eugenio; Guillén Pinto, Daniel; Rivas, Maria; Tori, Alfredo; Zegarra, Jaime; Cam, Luis; Castañeda, Anne; Villavicencio, Aasith; Ochoa Woodell, Theresa Jean
URI: https://hdl.handle.net/20.500.12866/6751
Fecha: 2019

Resumen:

Objective: To evaluate the combined prognostic value of neurological examination, head circumference and cranial ultrasound for neurodevelopmental delay (NDD) in very low birth weight (VLBW, <1500 g) preterm infants. Methods: Prospective follow-up study. Preterm infants with VLWB were assessed for NDD using the Mullen Scales of Early Learning test at 24 months of corrected age. Abnormal neurological examination (≥2 deviant items of Hammersmith neurological examination), microcephaly and major ultrasound abnormalities, each performed at term age, were evaluated as predictors of NDD in a multivariable Poisson model. Results: 35/132 infants (26.5%) had NDD. In the multivariable analysis, microcephaly (RR, 3.2; 95% CI, 1.6–6.7) and major ultrasound abnormalities (RR, 2.7; 95% CI, 1.3–5.7) were associated to NDD. The combination of the two tests showed the highest positive predictive value (100%; 95% CI, 51%–100%), while the combination of normal neurological examination, no major US findings and normal head size at term showed the highest negative predictive value (89%; 95% CI, 78%–95%). The maximum under receiver operating characteristic curve area was for microcephaly or major ultrasound abnormalities (AUC 0.74 (0.65–0.83)). Conclusion: The combination of head circumference, cranial ultrasound and neurological examination at term age is useful to predict NDD in VLBW preterm infants.

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