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| Research article summary (published 29 Apr 2009): |
Stability of neuromotor outcomes at 18 and 30 months of age after extremely low birth weight status.
Full Abstract
BACKGROUND: Extremely low birth weight (< or =1000 g) children have increased rates of cerebral palsy and other abnormal neurologic findings. OBJECTIVE: To investigate the stability of neuromotor findings between 18 and 30 months' adjusted age in extremely low birth weight infants. METHODS. Seven hundred nineteen extremely low birth weight infants with assessments at 18 and 30 months' adjusted age were included in this analysis. At each visit a neurologic examination, the modified gross motor function classification system, and the Bayley Scales of Infant Development II were administered. Logistic regression models were constructed to assess neonatal factors and neuromotor function at 18 months of age associated with stability in neuromotor function. RESULTS: Eighty-four percent of the children had agreement in neurologic/motor function at both visits. However, classification changed from normal to abnormal in 6% and from abnormal to normal in 10%. Diagnosis of cerebral palsy was consistent for 91% of the children, and the gross motor function classification system score was consistent for 83%. In multivariate models, factors associated with decreased severity or absence of cerebral palsy diagnosis at 30 months of age were higher gestational age, no periventricular leukomalacia or severe intraventricular hemorrhage, and a gross motor function classification system score of 0 (normal) at the 18-month visit, whereas factors associated with a new cerebral palsy diagnosis at 30 months of age were postnatal steroid use, periventricular leukomalacia or severe intraventricular hemorrhage, a gross motor function classification system score of > or =1 at 18 months of age, and asymmetrical limb movement at 18 months of age. CONCLUSIONS: Stability of neurologic diagnosis in 84% and cerebral palsy in 91% of the children is reassuring. However, for a significant percentage of children, the neurologic diagnosis changes between 18 and 30 months of age. The diagnosis of cerebral palsy may be delayed in some infants until an older adjusted age.
Author information
Author/s: Peralta-Carcelen, Myriam (M); Moses, Marybeth (M); Adams-Chapman, Ira (I); Gantz, Marie (M); Vohr, Betty R (BR); NICHD Neonatal Research Network; National Institutes of Health;
Affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA. mperalta(-atsign-)peds.uab.edu
Grants: U10 HD21364 (Agency:NICHD NIH HHS) ; U10 HD21385 (Agency:NICHD NIH HHS) ; U10 HD21397 (Agency:NICHD NIH HHS) ; U10 HD21415 (Agency:NICHD NIH HHS) ; U10 HD27851 (Agency:NICHD NIH HHS) ; U10 HD27853 (Agency:NICHD NIH HHS) ; U10 HD27856 (Agency:NICHD NIH HHS) ; U10 HD27871 (Agency:NICHD NIH HHS) ; U10 HD27880 (Agency:NICHD NIH HHS) ; U10 HD27904 (Agency:NICHD NIH HHS) ; U10 HD34216 (Agency:NICHD NIH HHS) ; U10 HD36790 (Agency:NICHD NIH HHS) ; U10 HD40461 (Agency:NICHD NIH HHS) ; U10 HD40689 (Agency:NICHD NIH HHS)
Journal and publication information
Publication Type: Journal Article; Research Support, N.I.H., Extramural
Journal: Pediatrics (Pediatrics), published in United States. (Language: eng)
Reference: 2009-May; vol 123 (issue 5) : pp e887-95
Dates: Created 2009/04/30; Completed 2009/05/26;
PMID: 19403482, status: MEDLINE (last retrieval date: 5/26/2009, IMS Date: 26 May 2009 00:00:00)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
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