Format

Send to

Choose Destination
Pediatrics. 2015 Jan;135(1):e32-42. doi: 10.1542/peds.2014-0898. Epub 2014 Dec 1.

Neuroimaging and neurodevelopmental outcome in extremely preterm infants.

Collaborators (229)

Jobe AH, Caplan MS, Oh W, Hensman AM, Alksninis B, Andrews D, Angela K, Barnett S, Cashore B, Caskey M, Francis K, Gingras D, Johnson K, Leach TM, Stephens BE, Watson VE, Walsh MC, Fanaroff AA, Newman NS, Siner BS, Zadell A, DiFiore J, Bhola M, Friedman HG, Yalcinkaya G, Goldberg RN, Cotten C, Ashley P, Auten KJ, Fisher KA, Foy KA, Freedman SF, Gustafson KE, Lohmeyer MB, Malcolm WF, Wallace DK, Stoll BJ, Buchter S, Piazza AJ, Carlton DP, Carter S, Fritz S, Hale EC, Hutchinson AK, LaRossa MM, Archer SW, Dusick AM, Lemons JA, Wilson LD, Hamer F, Cook AB, Herron DE, Lytle C, Minnich HM, Berberich MA, Blaisdell CJ, Gail DB, Kiley JP, Das A, Gantz MG, Newman JE, Hastings BK, McClure EM, Auman JO, Huitema CP, Poole K, Pickett JW 2nd, Wallace D, Zaterka-Baxter KM, Stevenson DK, Ball M, Bentley B, Bruno EF, DeAnda ME, DeBattista AM, Kohn JG, Proud MS, Pyle RP, Weiss HE, Frantz ID 3rd, Fiascone JM, Furey A, MacKinnon BL, Nylen E, Brussa A, Sibley C, Carlo WA, Ambalavanan N, Collins MV, Cosby SS, Phillips VA, Bailey KJ, Biasini FJ, Hopkins M, Johnston KC, Krzywanski S, Nelson KG, Patterson CS, Rector RV, Rodriguez L, Soong A, Whitley S, York S, Finer NN, Rasmussen MR, Wozniak PR, Rich W, Arnell K, Barbieri-Welge R, Ben-Tall A, Bridge R, Demetrio C, Fuller MG, Ito E, Lukasik M, Pontillo D, Posin D, Runyan C, Bell EF, Widness JA, Klein JM, Colaizy TT, Johnson KJ, Eastman DL, Duara S, Bauer CR, Everett-Thomas R, Calejo M, Diaz AN, Eguaras SM, Garcia A, Hamlin-Smith K, Berkowits MH, Hiriart-Fajardo S, Mathews EO, Pierre H, Zlotnik P, Riguard A, Stroerger A, Watterberg KL, Ohls RK, Rohr J, Lacy CB, Lowe J, Montman R, Brown S, Laroia N, Phelps DL, Markowitz GD, Reubens LJ, Hust D, Augostino L, Johnson JB, Burnell E, Gelbard H, Jensen RL, Kushner E, Merzbach J, Mink J, Torres C, Wang D, Yost K, Sánchez PJ, Rosenfeld CR, Salhab WA, Adams SS, Allen J, Grau L, Guzman A, Hensley G, Heyne ET, Lepps MH, Madden LA, Martin M, Miller NA, Morgan JS, Solis A, Torres LE, Boatman CT, Vasil DM, Wilder K, Kennedy KA, Tyson JE, Alaniz NI, Harris BF, Green C, Jiminez M, Lis AE, Martin S, McDavid GE, Morris BH, Poundstone ML, Reddoch S, Siddiki S, Tate PL, Whitely LL, Wright SL, Yoder BA, Faix RG, Baker S, Bird K, Bullwinkle AE, Burnett J, Cole L, Osborne KA, Spencer C, Steele R, Steffen M, Weaver-Lewis K, O'Shea T, Dillard RG, Washburn LK, Peters NJ, Jackson BG, Chiu K, Allred DE, Goldstein DJ, Halfond R, Peterson C, Waldrep EL, Welch CD, Morris MW, Hounshell GW, Shankaran S, Sood BG, Bara R, Billian E, Goldston LA, Johnson M.

Author information

1
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, California; srhintz@stanford.edu.
2
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, California;
3
Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, District of Columbia;
4
Department of Pediatric Imaging, Children's Hospital of Michigan, Wayne State School of Medicine, Detroit, Michigan;
5
Departments of Neonatology, and.
6
Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina;
7
Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville, Maryland;
8
Department of Pediatrics, University of Texas Medical School-Houston, Houston, Texas;
9
Division of Neonatology, University of Alabama-Birmingham, Birmingham, Alabama;
10
Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio;
11
Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, Rhode Island;
12
Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah;
13
Departments of Neonatology, and Pediatrics, University of California-San Diego, San Diego, California;
14
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas;
15
Department of Pediatrics, University of Iowa, Iowa City, Iowa;
16
Pediatrics, University of California-San Diego, San Diego, California;
17
Department of Pediatrics, Wayne State University, Detroit, Michigan;
18
Department of Pediatrics, Duke University, Durham, North Carolina;
19
Department of Pediatrics, University of Rochester Medical Center, Rochester, New York;
20
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana;
21
Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, Massachusetts;
22
Department of Pediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, Georgia;
23
University of New Mexico Health Sciences Center, Albuquerque, New Mexico; and.
24
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.

Abstract

BACKGROUND:

Extremely preterm infants are at risk for neurodevelopmental impairment (NDI). Early cranial ultrasound (CUS) is usual practice, but near-term brain MRI has been reported to better predict outcomes. We prospectively evaluated MRI white matter abnormality (WMA) and cerebellar lesions, and serial CUS adverse findings as predictors of outcomes at 18 to 22 months' corrected age.

METHODS:

Early and late CUS, and brain MRI were read by masked central readers, in a large cohort (n = 480) of infants <28 weeks' gestation surviving to near term in the Neonatal Research Network. Outcomes included NDI or death after neuroimaging, and significant gross motor impairment or death, with NDI defined as cognitive composite score <70, significant gross motor impairment, and severe hearing or visual impairment. Multivariable models evaluated the relative predictive value of neuroimaging while controlling for other factors.

RESULTS:

Of 480 infants, 15 died and 20 were lost. Increasing severity of WMA and significant cerebellar lesions on MRI were associated with adverse outcomes. Cerebellar lesions were rarely identified by CUS. In full multivariable models, both late CUS and MRI, but not early CUS, remained independently associated with NDI or death (MRI cerebellar lesions: odds ratio, 3.0 [95% confidence interval: 1.3-6.8]; late CUS: odds ratio, 9.8 [95% confidence interval: 2.8-35]), and significant gross motor impairment or death. In models that did not include late CUS, MRI moderate-severe WMA was independently associated with adverse outcomes.

CONCLUSIONS:

Both late CUS and near-term MRI abnormalities were associated with outcomes, independent of early CUS and other factors, underscoring the relative prognostic value of near-term neuroimaging.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00233324.

KEYWORDS:

MRI; neurodevelopmental; neuroimaging; preterm infant; ultrasound

PMID:
25554820
PMCID:
PMC4279063
DOI:
10.1542/peds.2014-0898
[Indexed for MEDLINE]
Free PMC Article

Publication types, MeSH terms, Secondary source ID, Grant support

Publication types

MeSH terms

Secondary source ID

Grant support

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center