Journal article
Preterm Neuroimaging and School-Age Cognitive Outcomes
Pediatrics (Evanston), Vol.142(1), p.e20174058
07/2018
DOI: 10.1542/peds.2017-4058
PMCID: PMC6128951
PMID: 29945955
Abstract
Children born extremely preterm are at risk for cognitive difficulties and disability. The relative prognostic value of neonatal brain MRI and cranial ultrasound (CUS) for school-age outcomes remains unclear. Our objectives were to relate near-term conventional brain MRI and early and late CUS to cognitive impairment and disability at 6 to 7 years among children born extremely preterm and assess prognostic value.
A prospective study of adverse early and late CUS and near-term conventional MRI findings to predict outcomes at 6 to 7 years including a full-scale IQ (FSIQ) <70 and disability (FSIQ <70, moderate-to-severe cerebral palsy, or severe vision or hearing impairment) in a subgroup of Surfactant Positive Airway Pressure and Pulse Oximetry Randomized Trial enrollees. Stepwise logistic regression evaluated associations of neuroimaging with outcomes, adjusting for perinatal-neonatal factors.
A total of 386 children had follow-up. In unadjusted analyses, severity of white matter abnormality and cerebellar lesions on MRI and adverse CUS findings were associated with outcomes. In full regression models, both adverse late CUS findings (odds ratio [OR] 27.9; 95% confidence interval [CI] 6.0-129) and significant cerebellar lesions on MRI (OR 2.71; 95% CI 1.1-6.7) remained associated with disability, but only adverse late CUS findings (OR 20.1; 95% CI 3.6-111) were associated with FSIQ <70. Predictive accuracy of stepwise models was not substantially improved with the addition of neuroimaging.
Severe but rare adverse late CUS findings were most strongly associated with cognitive impairment and disability at school age, and significant cerebellar lesions on MRI were associated with disability. Near-term conventional MRI did not substantively enhance prediction of severe early school-age outcomes.
Details
- Title: Subtitle
- Preterm Neuroimaging and School-Age Cognitive Outcomes
- Creators
- Susan R Hintz - Division of Neonatal and Developmental Medicine, Department of Pediatrics, School of Medicine, Stanford University and Lucile Packard Children's Hospital, Palo Alto, California; srhintz@stanford.eduBetty R Vohr - Department of Pediatrics, Women and Infants Hospital and Brown University, Providence, Rhode IslandCarla M Bann - Social, Statistical, and Environmental Sciences Unit, Research Triangle Institute International, Research Triangle Park, North CarolinaH Gerry Taylor - Department of Pediatrics, Rainbow Babies and Children's Hospital and Case Western Reserve University, Cleveland, OhioAbhik Das - Social, Statistical, and Environmental Sciences Unit, Research Triangle Institute International, Rockville, MarylandKathryn E Gustafson - Department of Pediatrics, Duke University, Durham, North CarolinaKimberly Yolton - Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OhioVictoria E Watson - Department of Pediatrics, Women and Infants Hospital and Brown University, Providence, Rhode IslandJean Lowe - Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New MexicoMaria Elena DeAnda - Division of Neonatal and Developmental Medicine, Department of Pediatrics, School of Medicine, Stanford University and Lucile Packard Children's Hospital, Palo Alto, CaliforniaM Bethany Ball - Division of Neonatal and Developmental Medicine, Department of Pediatrics, School of Medicine, Stanford University and Lucile Packard Children's Hospital, Palo Alto, CaliforniaNeil N Finer - Department of Pediatrics, University of California at San Diego, San Diego, CaliforniaKrisa P Van Meurs - Division of Neonatal and Developmental Medicine, Department of Pediatrics, School of Medicine, Stanford University and Lucile Packard Children's Hospital, Palo Alto, CaliforniaSeetha Shankaran - Department of Pediatrics, Wayne State University, Detroit, MichiganAthina Pappas - Department of Pediatrics, Wayne State University, Detroit, MichiganPatrick D Barnes - Division of Neonatal and Developmental Medicine, Department of Pediatrics, School of Medicine, Stanford University and Lucile Packard Children's Hospital, Palo Alto, CaliforniaDorothy Bulas - Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, District of ColumbiaJamie E Newman - Social, Statistical, and Environmental Sciences Unit, Research Triangle Institute International, Research Triangle Park, North CarolinaDeanne E Wilson-Costello - Department of Pediatrics, Rainbow Babies and Children's Hospital and Case Western Reserve University, Cleveland, OhioRoy J Heyne - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TexasHeidi M Harmon - Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IndianaMyriam Peralta-Carcelen - Division of Neonatology, University of Alabama at Birmingham, Birmingham, AlabamaIra Adams-Chapman - Department of Pediatrics, School of Medicine, Emory University and Children's Healthcare of Atlanta, Atlanta, GeorgiaAndrea Freeman Duncan - Department of Pediatrics, McGovern Medical School, University of Texas at Houston, Houston, TexasJanell Fuller - Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New MexicoYvonne E Vaucher - Department of Pediatrics, University of California at San Diego, San Diego, CaliforniaTarah T Colaizy - Department of Pediatrics, University of Iowa, Iowa City, IowaSarah Winter - Division of Neonatology, Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, UtahElisabeth C McGowan - Division of Newborn Medicine, Department of Pediatrics, Tufts Medical Center, Floating Hospital for Children, Boston, Massachusetts; andRicki F Goldstein - Department of Pediatrics, Duke University, Durham, North CarolinaRosemary D Higgins - Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
- Resource Type
- Journal article
- Publication Details
- Pediatrics (Evanston), Vol.142(1), p.e20174058
- DOI
- 10.1542/peds.2017-4058
- PMID
- 29945955
- PMCID
- PMC6128951
- NLM abbreviation
- Pediatrics
- ISSN
- 0031-4005
- eISSN
- 1098-4275
- Publisher
- American Academy of Pediatrics; United States
- Grant note
- U10 HD053124 / NICHD NIH HHS UG1 HD053089 / NICHD NIH HHS UG1 HD040492 / NICHD NIH HHS UG1 HD027904 / NICHD NIH HHS U24 HD095254 / NICHD NIH HHS U10 HD053119 / NICHD NIH HHS UG1 HD027880 / NICHD NIH HHS UG1 HD053109 / NICHD NIH HHS U10 HD021373 / NICHD NIH HHS U10 HD040492 / NICHD NIH HHS U10 HD036790 / NICHD NIH HHS UL1 RR025008 / NCRR NIH HHS U10 HD053089 / NICHD NIH HHS U10 HD040689 / NICHD NIH HHS U10 HD027904 / NICHD NIH HHS U10 HD053109 / NICHD NIH HHS UG1 HD087226 / NICHD NIH HHS U10 HD027856 / NICHD NIH HHS U10 HD027880 / NICHD NIH HHS U10 HD021364 / NICHD NIH HHS U10 HD027851 / NICHD NIH HHS UG1 HD087229 / NICHD NIH HHS U10 HD034216 / NICHD NIH HHS UG1 HD040689 / NICHD NIH HHS UL1 RR025744 / NCRR NIH HHS U10 HD021385 / NICHD NIH HHS UG1 HD034216 / NICHD NIH HHS U10 HD040461 / NICHD NIH HHS UG1 HD021364 / NICHD NIH HHS UG1 HD027853 / NICHD NIH HHS UG1 HD068278 / NICHD NIH HHS
- Language
- English
- Date published
- 07/2018
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984071796502771
Metrics
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