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Movement, imaging and neurobehavioral assessment as predictors of cerebral palsy in preterm infants

Journal of Perinatology volume 27, pages 225–229 (2007)Cite this article

Abstract

Objective:

To study the relative efficacy of three early predictors of cerebral palsy.

Method:

One Hundred and thirty infants with birth weight <1500 g were recruited. Video recordings of spontaneous general movements were made at 36 and 52 weeks postconceptional age. Magnetic resonance imaging and the neurobehavioral assessment of the preterm infant were done at 36 weeks postconceptional age. Follow-up neurological examination and Bayley assessments were made at 18 months corrected age to make early identification of cerebral palsy.

Results:

Magnetic resonance imaging gave the best specificity and accuracy of 91 and 84% respectively. General movements at 52 weeks showed an improved specificity and accuracy over performance at 36 weeks postconceptional age. The negative predictive value for all methods tested was between 90 and 97%. Combining the results of magnetic resonance imaging and the neurobehavioral assessment improved the sensitivity of prediction to 80%, suggesting that a holistic approach to early detection of cerebral lesions is preferable to a single test.

Conclusions:

The majority of infants who appeared to behave within normal limits and exhibit normal brain structure in the newborn period were classified as neurologically intact at follow-up.

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References

  1. Vohr BR, Wright LL, Dusick AM, Mele L, Verter J, Steichen JJ et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network 1993–1994. Pediatrics 2000; 105 (6): 1216–1226.

    Article  CAS  Google Scholar 

  2. Blauw-Hosper CH, Hadders-Algra M . A systematic review of the effects of early intervention on motor development. Dev Med Child Neurol 2005; 47 (6): 421–432.

    Article  Google Scholar 

  3. Prechtl HFR, Ferrari F, Cioni G . Predictive value of general movements in asphyxiated fullterm infants. Early Human Development 1993; 35: 91–120.

    Article  CAS  Google Scholar 

  4. Prechtl HFR . State of the art of a new functional assessment of the young nervous system. An early predictor of cerebral palsy. Early Human Development 1997; 50: 1–11.

    Article  CAS  Google Scholar 

  5. Groen SE, de Blecourt ACE, Postema K, Hadders-Algra M . General movements in early infancy predict neuromotor development at 9 to 12 years of age. Dev Med Child Neurol 2005; 47: 731–738.

    Article  Google Scholar 

  6. Prechtl HFR, Einspieler C, Cioni G, Bos AF, Ferrari F, Sontheimer D . An early marker for neurological deficits after perinatal brain lesions. Lancet 1997; 349: 1361–1363.

    Article  CAS  Google Scholar 

  7. Garcia JM, Gherpelli JLD, Leone CR . The role of spontaneous general movement assessment in the neurological outcome of cerebral lesions in preterm infants. J Pediatr (Rio J) 2004; 80 (4): 296–305.

    Article  Google Scholar 

  8. Ferrari F, Cioni G, Prechtl HFR . Qualitative changes of general movements in preterm infants with brain lesions. Early Human Development 1990; 23: 193–231.

    Article  CAS  Google Scholar 

  9. Cioni G, Ferrari F, Einspieler C, Paolicelli PB, Barbani MT, Prechtl HFR . Comparison between observation of spontaneous movements and neurologic examination in preterm infants. J Pediatr 1997; 130: 704–711.

    Article  CAS  Google Scholar 

  10. Bos AF . Analysis of movement quality in preterm infants. Europ J Obstet Gyn Repro Biol 1998; 76: 117–119.

    Article  CAS  Google Scholar 

  11. Cioni G, Prechtl H . Preterm and early post-term motor behavior in low-risk premature infants. Early Human Development 1990; 23: 159–191.

    Article  CAS  Google Scholar 

  12. Maas YGH . Early Neurological Development, Growth and Nutrition in Very Preterm Infants. Thesis University of Amsterdam: Amsterdam., 1999.

    Google Scholar 

  13. Mirmiran M, Barnes PD, Keller K, Constantinou JC, Fleisher BE, Hintz SR et al. Neonatal brain magnetic resonance imaging before discharge is better than serial cranial ultrasound in predicting cerebral palsy in very low birth weight preterm infants. Pediatrics 2004; 114 (4): 992–998.

    Article  Google Scholar 

  14. Korner AF, Thom VA . Neurobehavioral Assessment of the Preterm Infant. Child Development Media, Inc.: Van Nuys, 2000.

    Google Scholar 

  15. Prechtl H . Qualitative changes of spontaneous movements in fetus and preterm infant are a marker of neurological dysfunction. Early Human Devel 1990; 23: 151–158.

    Article  CAS  Google Scholar 

  16. Hopkins B, Prechtl HFR. (Eds) A Qualitative Approach to the Development of Movements During Early Infancy. Continuity of Neural Functions from Prenatal to Postnatal Life. Clinics in Developmental Medicine 1984. Blackwell Scientific Publications: Oxford.

    Google Scholar 

  17. Hadders-Algra M, Prechtl HFR . Developmental course of general movements in early infancy@ 1@ Descriptive analysis of change in form. Early Human Devel 1992; 28: 201–213.

    Article  CAS  Google Scholar 

  18. Amiel-Tison C, Grenier A . Neurologic Assessment Within the First Year of Life. Oxford University Press: New York, 1986.

    Google Scholar 

  19. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B . Gross motor function classification system for cerebral palsy. Dev Med Child Neurol 1997; 39: 214–223.

    Article  CAS  Google Scholar 

  20. Bayley N . Bayley Scales of Infant Development. 2nd edn The Psychological Corporation: San Antonio, 1997.

    Google Scholar 

  21. Korner AF, Stevenson DK, Kraemer HC, Spiker D, Scott DT, Constantinou J et al. Prediction of the development of low birth weight preterm infants by a new neonatal medical index. Dev Behav Pediatr 1993; 14 (2): 106–111.

    Article  CAS  Google Scholar 

  22. De Vries LS, Van Haastert IL, Rademaker KJ, Koopman C, Groenendaal F . Ultrasound abnormalities preceding cerebral palsy in high-risk preterm infants. J Pediatr 2004; 144 (6): 815–820.

    Article  Google Scholar 

  23. Byrne EM, Rose J, Butler E, Kermoian R, Constantinou JC . Early detection of cerebral palsy from spontaneous movements using the NASA Postural Video Analysis Tool. Dev Med Child Neurol 2004; 99: 19.

    Google Scholar 

Download references

Acknowledgements

This work was supported in part by a grant from the David and Lucile Packard Foundation, grant 5 M01 RR000070 from the National Institutes of Health awarded to the General Clinical Research Center, The Mary L. Johnson Research Fund, Innovations in Patient Care, and Lucile Packard Foundation for Children's Health.

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Authors and Affiliations

  1. Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA

    J C Constantinou, M Mirmiran & B E Fleisher

  2. Centre for Health and Social Care Improvement (CHSCI), University of Wolverhampton, Wolverhampton, UK

    E N Adamson-Macedo

Authors
  1. J C Constantinou
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  2. E N Adamson-Macedo
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  3. M Mirmiran
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  4. B E Fleisher
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Correspondence to J C Constantinou.

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Constantinou, J., Adamson-Macedo, E., Mirmiran, M. et al. Movement, imaging and neurobehavioral assessment as predictors of cerebral palsy in preterm infants. J Perinatol 27, 225–229 (2007). https://doi.org/10.1038/sj.jp.7211664

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