Original ArticlesUltrasound abnormalities preceding cerebral palsy in high-risk preterm infants
Section snippets
Patients and methods
All preterm infants with a gestational age (GA) ≤36 weeks, admitted to the neonatal intensive care unit of the Wilhelmina Children's Hospital (a tertiary referral center) and born between January 1990 and January 1999, were studied prospectively using cranial US. Infants with chromosomal disorders, congenital abnormalities, congenital infections, and proven metabolic disorders were excluded. Those who survived were seen in the follow-up clinic at regular intervals. The pediatric physiotherapist
Results
Of the 2139 children who met the entry criteria, 1636 were ≤32 weeks GA; 176 (11%) died, and 1460 infants survived. Five hundred and three infants with a GA of 33 to 36 weeks were admitted; 34 (7%) died, and 469 survived the neonatal period. More than 80% of all infants and all but 2 of those with major US abnormalities were seen in the follow-up clinic. If any of the children without major US abnormalities go on to develop CP, they are referred to our hospital, either to our neonatal follow-up
Discussion
Using sequential high-resolution cranial US until discharge and at 40 weeks PMA, major US abnormalities were detected in 79% of the children who developed CP during infancy. Only 7 of 105 children with CP had completely normal US findings. CP was mild in the infants with a normal US scan, and all achieved independent walking. US was unable to detect abnormalities in 3 infants who subsequently developed cerebellar ataxia. Two of these 3 infants with ataxia were severely growth retarded, and
References (35)
- et al.
Magnetic resonance and cranial ultrasound characteristics of periventricular white matter abnormalities in newborn infants
Clin Radiol
(2001) - et al.
Incidence and evaluation of subependymal haemorrhage: a study of children with a birthweight less than 1500 g
J Pediatr
(1978) - et al.
The spectrum of leukomalacia using cranial ultrasound
Behav Brain Res
(1992) - et al.
White matter disorders of prematurity: association with intraventricular hemorrhage and ventriculomegaly. The Developmental Epidemiology Network
J Pediatr
(1999) - et al.
Prediction of death and major handicap in very preterm infants by brain ultrasound
Lancet
(1981) - et al.
Risk factors in the development of intraventricular haemorrhage in the preterm newborn
Arch Dis Child
(1982) - et al.
Antecedents of periventricular haemorrhage in infants weighing 1250 g or less at birth
Arch Dis Child
(1984) - et al.
Hemorrhagic periventricular leukomalacia in the neonate: a real-time ultrasound study
Pediatrics
(1983) - et al.
Haemorrhagic leukomalacia: diagnosis by real-time ultrasound and correlation with autopsy findings
Pediatrics
(1982) - et al.
Comparison of findings on cranial ultrasound and magnetic resonance imaging in preterm infants
Pediatrics
(2001)
White matter injury in the premature infant: a comparison between serial cranial sonographic and MR findings at term
Am J Neuroradiol
Limitations of ultrasonography for diagnosing white matter damage in preterm infants
Arch Dis Child Fetal Neonatal Edition
Comparing the diagnosis of white matter injury in premature newborns with serial MR imaging and transfontanel ultrasonography findings
Am J Neuroradiol
Prenatal events and the risk of cerebral palsy in very low birth weight infants
Am J Epidemiol
Perinatal infection is an important risk factor for cerebral palsy in very low birthweight infants
Dev Med Child Neurol
Neonatal cytokines and cerebral palsy in very preterm infants
Pediatr Res
Serial head ultrasound studies in preterm infants: how many normal studies does one infant need to exclude significant abnormalities?
J Perinatol
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