Stability of Neuromotor Outcomes at 18 and 30 Months of Age After Extremely Low Birth Weight Status Export

@article{citeulike:4415378, abstract = {BACKGROUND. Extremely low birth weight ([\≤]1000 g) children have increased rates of cerebral palsy and other abnormal neurologic findings. OBJECTIVE. To investigate the stability of neuromotor findings between 18 and 30 months' adjusted age in extremely low birth weight infants. METHODS. Seven hundred nineteen extremely low birth weight infants with assessments at 18 and 30 months' adjusted age were included in this analysis. At each visit a neurologic examination, the modified gross motor function classification system, and the Bayley Scales of Infant Development II were administered. Logistic regression models were constructed to assess neonatal factors and neuromotor function at 18 months of age associated with stability in neuromotor function. RESULTS. Eighty-four percent of the children had agreement in neurologic/motor function at both visits. However, classification changed from normal to abnormal in 6\% and from abnormal to normal in 10\%. Diagnosis of cerebral palsy was consistent for 91\% of the children, and the gross motor function classification system score was consistent for 83\%. In multivariate models, factors associated with decreased severity or absence of cerebral palsy diagnosis at 30 months of age were higher gestational age, no periventricular leukomalacia or severe intraventricular hemorrhage, and a gross motor function classification system score of 0 (normal) at the 18-month visit, whereas factors associated with a new cerebral palsy diagnosis at 30 months of age were postnatal steroid use, periventricular leukomalacia or severe intraventricular hemorrhage, a gross motor function classification system score of [\≥]1 at 18 months of age, and asymmetrical limb movement at 18 months of age. CONCLUSIONS. Stability of neurologic diagnosis in 84\% and cerebral palsy in 91\% of the children is reassuring. However, for a significant percentage of children, the neurologic diagnosis changes between 18 and 30 months of age. The diagnosis of cerebral palsy may be delayed in some infants until an older adjusted age. 10.1542/peds.2008-0135}, author = {Peralta-Carcelen, Myriam and Moses, Marybeth and Adams-Chapman, Ira and Gantz, Marie and Vohr, Betty R. and For}, citeulike-article-id = {4415378}, citeulike-linkout-0 = {http://dx.doi.org/10.1542/peds.2008-0135}, citeulike-linkout-1 = {http://pediatrics.aappublications.org/cgi/content/abstract/123/5/e887?ct=ct}, day = {1}, doi = {10.1542/peds.2008-0135}, journal = {Pediatrics}, keywords = {assessment, bayley, birth, cerebal, cp, development, infant, lbw, motor, palsy, prediction}, month = {May}, number = {5}, pages = {e887--895}, posted-at = {2009-04-28 15:25:30}, priority = {2}, title = {Stability of Neuromotor Outcomes at 18 and 30 Months of Age After Extremely Low Birth Weight Status}, url = {http://dx.doi.org/10.1542/peds.2008-0135}, volume = {123}, year = {2009} }

TY - JOUR ID - citeulike:4415378 L3 - citeulike-article-id:4415378 N2 - BACKGROUND. Extremely low birth weight ([≤]1000 g) children have increased rates of cerebral palsy and other abnormal neurologic findings. OBJECTIVE. To investigate the stability of neuromotor findings between 18 and 30 months' adjusted age in extremely low birth weight infants. METHODS. Seven hundred nineteen extremely low birth weight infants with assessments at 18 and 30 months' adjusted age were included in this analysis. At each visit a neurologic examination, the modified gross motor function classification system, and the Bayley Scales of Infant Development II were administered. Logistic regression models were constructed to assess neonatal factors and neuromotor function at 18 months of age associated with stability in neuromotor function. RESULTS. Eighty-four percent of the children had agreement in neurologic/motor function at both visits. However, classification changed from normal to abnormal in 6% and from abnormal to normal in 10%. Diagnosis of cerebral palsy was consistent for 91% of the children, and the gross motor function classification system score was consistent for 83%. In multivariate models, factors associated with decreased severity or absence of cerebral palsy diagnosis at 30 months of age were higher gestational age, no periventricular leukomalacia or severe intraventricular hemorrhage, and a gross motor function classification system score of 0 (normal) at the 18-month visit, whereas factors associated with a new cerebral palsy diagnosis at 30 months of age were postnatal steroid use, periventricular leukomalacia or severe intraventricular hemorrhage, a gross motor function classification system score of [≥]1 at 18 months of age, and asymmetrical limb movement at 18 months of age. CONCLUSIONS. Stability of neurologic diagnosis in 84% and cerebral palsy in 91% of the children is reassuring. However, for a significant percentage of children, the neurologic diagnosis changes between 18 and 30 months of age. The diagnosis of cerebral palsy may be delayed in some infants until an older adjusted age. 10.1542/peds.2008-0135 IS - 5 JF - Pediatrics EP - 895 TI - Stability of Neuromotor Outcomes at 18 and 30 Months of Age After Extremely Low Birth Weight Status VL - 123 SP - e887 KW - assessment KW - bayley KW - birth KW - cerebal KW - cp KW - development KW - infant KW - lbw KW - motor KW - palsy KW - prediction AU - Peralta-Carcelen, Myriam AU - Moses, Marybeth AU - Adams-Chapman, Ira AU - Gantz, Marie AU - Vohr, Betty AU - For PY - 2009/05/01/ UR - http://dx.doi.org/10.1542/peds.2008-0135 ER -