Developmental outcome of preterm infants with transient neuromotor abnormalities
D. B. D'Eugenio, T. A. Slagle, B. B. Mettelman and S. J. Gross
Department of Pediatrics, State University of New York Health Science Center, Syracuse 13210.
OBJECTIVE--To determine the relationship between transiently abnormal
neurologic findings in preterm infants and subsequent cognitive outcome at
4 years of age. DESIGN--Prospective 4-year follow-up. SETTING--Regional
perinatal center in Syracuse, NY. PARTICIPANTS--One hundred thirty-one of
135 consecutively born infants of no more than 32 weeks of gestational age;
98% followed up from birth to 4 years of age. INTERVENTIONS--None.
MEASUREMENTS AND MAIN RESULTS--Based on neuromotor evaluations performed at
6 and 15 months of age, two groups of infants were identified. One group
had abnormal neurologic findings at 6 months of age that had resolved by 15
months of age (transiently abnormal group). The other group had normal
neuromotor findings at both 6 and 15 months of age (normal group). The
transiently abnormal group had significantly poorer scores on the Bayley
Mental scale at 6 months of age (90 +/- 15 vs 108 +/- 10; P < .001), 15
months (91 +/- 21 vs 105 +/- 12; P < .001), and 24 months (91 +/- 19 vs
101 +/- 17; P < .001). However, at 4 years of age, cognitive performance
on the McCarthy Scales was similar for the transiently abnormal and normal
groups (General Cognitive index, 93 +/- 13 and 95 +/- 14, respectively).
The incidence of poor cognitive outcome (Cognitive index < 84) decreased
from 39% at 2 years of age to 18% at 4 years of age in the group with a
history of transient neurologic abnormalities but remained unchanged (16%
to 18%) in the normal group. CONCLUSION--Early neurologic abnormalities
that are transient did not predict cognitive delays at 4 years of age in
preterm infants.
