अमूर्त

Prediction of short term developmental outcomes in preterm infants utilizing cranial ultrasound examination

Huynh Quang Huy, Ton Nu Van Anh, Nguyen Huu Son, Tran Thi Thuy Quynh

Background: Premature birth is associated with brain lesions mostly resulting from hypoxia-ischaemia and haemorrhage. Clinicians routinely need to provide parents and carers with prognostic information for their vulnerable infants, and most do this with the aid of some forms of neuroimaging. Studies of the relationship between ultrasound images from preterm newborns and developmental delay at 6 months’ corrected age. Methods: We evaluated associations between ultrasound-defined lesions of the brain and developmental delays at 6 months’ corrected age in 79 children born before the 37th postmenstrual week. Brain ultrasound scans were read for concordance on 4 lesions: Intraventricular haemorrhage; Periventricular leukomalacia; Ventricular dilatation; Other lesion (congenital anomaly, cystic lesion). Developmental assessment at 6 months by using Denver II developmental screening test and a neurologic examination. Results: Fully 24.1% of all of the children had delayed mental and/or psychomotor development. Ultrasound abnormalities were more strongly associated with developmental delays. They were intraventricular haemorrhage (RR 9.6) had periventricular leukomalacia (RR 10.3), ventricular dilatation (RR 18), congenital anomaly (RR 18) and cystic lesion (RR 18). Several peninatal variables including afgar score at 5 mins <7, hyaline membrane disease and mechanical ventilation are each associated with an elevated risk of developmental delays. Conclusion: Cranial ultrasound provides a good screening tool for detection of brain injury in preterm infants during hospitalisation. Future studies are necessary to evaluate whether MRI of preterm infants can lead to a more accurate prediction of the neurodevelopmental impairment.