Early clinical and MRI biomarkers of cognitive and motor outcomes in very preterm born infants

George, Joanne M.; Colditz, Paul B.; Chatfield, Mark D.; Fiori, Simona; Pannek, Kerstin; Fripp, Jürgen; Guzzetta, Andrea; Rose, Stephen; Ware, Robert S.; Boyd, Roslyn N.

doi:10.1038/s41390-021-01399-5

Cited by 9 publications

(18 citation statements)

References 38 publications

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“…Our findings reflect trends from both clinical and research settings, with the classification of CP from research settings producing a higher predictive value. CP will need to be confirmed with GMFCS classification at a later age (i.e., 5 years of age or older) according to Australian CP register guidelines [ 45 ], and further assessment at 6 years is planned for the current cohort [ 25 ]. This study supports the notion that the GMA has better prediction for CP than neurodevelopmental delay [ 12 , 13 , 14 ] and that the MOS-R may provide the extra information needed in addition to fidgety movements alone to detect motor, cognitive, or neurosensory motor impairment.…”

Section: Discussionmentioning

confidence: 99%

“…Participants included infants born very preterm, between February 2016 and December 2018, who were free from congenital anomalies from the Prediction of Preterm Brain Outcomes (PREBO) [ 25 ]. Infants were recruited prospectively from the Royal Brisbane Women’s Hospital (RBWH).…”

Section: Methodsmentioning

confidence: 99%

“…Parents of infants provided written informed consent to participate, and the study was approved by the Human Research Ethics Committees at the Royal Brisbane Women’s Hospital (HREC/15/QRCH) and The University of Queensland (2015000290) and registered on the Australian New Zealand Clinical Trial Registry (ACTRN12615000591550). The studied cohort [ 3 , 25 ] presents those with completed 2-year data.…”

Section: Methodsmentioning

confidence: 99%

“…CP was assessed at 2 years’ CA by pediatricians who administered standardized neurological assessments and classified CP using the GMFCS [ 32 ] as well as CP motor distribution [ 33 ], and as described in previous protocols/study [ 3 , 25 ]. CP was classified as definite, possible (where children had neurological abnormalities, but could not be clearly classified as CP), or no CP.…”

Section: Methodsmentioning

confidence: 99%

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Early Motor Repertoire of Very Preterm Infants and Relationships with 2-Year Neurodevelopment

Kwong

Boyd

Chatfield

et al. 2022

JCM

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The Motor Optimality Score, revised (MOS-R) is an extension of the Prechtl General Movements Assessment. This study aims to determine the relationship between MOS-R and 2-year neurodevelopmental outcomes in a cohort of 169 infants born very preterm (<31 weeks’ gestational age), and to examine the predictive validity of the MOS-R at 3–4 months’ corrected age (CA) above perinatal variables associated with poor outcomes, including Prechtl fidgety movements. Development at 2 years’ CA was assessed using Bayley Scales of Infant and Toddler Development, Third edition (Bayley-III) (motor/cognitive impairment: Bayley-III ≤ 85) and Neurological, Sensory, Motor, Developmental Assessment (NSMDA) (neurosensory motor impairment: NSMDA ≥ 12). Cerebral palsy (CP) was classified at 2 years as definite or clinical. The MOS-R was related to 2-year outcomes: Bayley-III motor (BMOS-R = 1.24 95% confidence interval (0.78, 1.70)), cognitive (BMOS-R = 0.91 (0.48, 1.35)), NSMDA scores (BMOS-R = −0.34 (−0.42, −0.25)), definite CP (odds ratio [OR] 0.67 (0.53, 0.86)), clinical CP (OR 0.74 (0.66, 0.83)) for each 1-point increase in MOS-R. MOS-R ≤ 23 predicted motor (sensitivity 78% (60–91%); specificity 63% (54–72%)) and neurosensory motor impairment (sensitivity 86% (64–97%); specificity 59% (51–68%)). The MOS-R is strongly related to CP and motor and cognitive delay at 2 years and is a good predictor of motor and neurosensory motor impairment.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Early Motor Repertoire of Very Preterm Infants and Relationships with 2-Year Neurodevelopment

Kwong

Boyd

Chatfield

et al. 2022

JCM

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“…Neonatal Magnetic Resonance Imaging (MRI) for detecting brain injury in this population has gained support as a useful prognostic tool. 12 – 15 Many regional hospitals and those in low- and middle-income settings do not have access to neonatal MRI, thus it is important to establish the diagnostic accuracy of more accessible tools such as a clinical neurological assessment.…”

Section: Introductionmentioning

confidence: 99%

Neurological examination at 32-weeks postmenstrual age predicts 12-month cognitive outcomes in very preterm-born infants

et al. 2022

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Background To determine the diagnostic accuracy of Hammersmith Neonatal Neurological Examination (HNNE) at 30–32 weeks postmenstrual age (PMA, ‘Early’) and term equivalent age (TEA) in infants born <31 weeks PMA to predict cognitive outcomes at 12 months corrected age (CA). Methods Prospective cohort study of 119 infants (73 males; median 28.4 weeks gestational age at birth) who underwent Early and TEA HNNE. At 12 months CA, 104 participants completed Bayley Scales of Infant and Toddler Development, 3rd Edition, (Bayley-III). Optimum cut-off points for each HNNE subscale were determined to establish diagnostic accuracy for predicting adverse cognitive outcomes on the Bayley-III Cognitive Composite Scale (≤85). Results The best diagnostic accuracy for HNNE total score at 30–32 weeks PMA predicting cognitive impairment occurred at cut-off ≤16.7 (sensitivity (Se) = 71%, specificity (Sp) = 51%). The Abnormal Signs subscale demonstrated the best balance of sensitivity/specificity combination (Se = 71%, Sp = 71%; cut-off ≤1.5). For HNNE at TEA, the total score at cut-off ≤24.5 had Se = 71% and Sp = 47% for predicting cognitive impairment. The Tone Patterns subscale demonstrated the strongest diagnostic accuracy at TEA (Se = 71%, Sp = 63%; cut-off ≤3). Conclusions Early and TEA HNNE demonstrated moderate diagnostic accuracy for cognitive outcomes at 12-months CA in infants born <31 weeks gestational age. Clinical Trial Registration: Australian New Zealand Clinical Trials Registry; Trial Registration Number: ACTRN12613000280707; web address of trial: http://www.ANZCTR.org.au/ACTRN12613000280707.aspx. Impact Early Hammersmith Neonatal Neurological Examination (HNNE) assessment at 30–32 weeks postmenstrual age has moderate diagnostic accuracy for cognitive outcomes at 12 months corrected age in infants born <31 weeks gestation. Early HNNE at 30–32 weeks has stronger predictive validity than HNNE at term equivalent age. Early HNNE may provide an early marker for risk-stratification to optimise the planning of post-discharge support and follow-up services for infants born preterm.

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Associations between malaria in pregnancy and neonatal neurological outcomes

Lawford

Nuamah

Liley

et al. 2021

International Journal of Infectious Diseases

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Early clinical and MRI biomarkers of cognitive and motor outcomes in very preterm born infants

Cited by 9 publications

References 38 publications

Early Motor Repertoire of Very Preterm Infants and Relationships with 2-Year Neurodevelopment

Early Motor Repertoire of Very Preterm Infants and Relationships with 2-Year Neurodevelopment

Neurological examination at 32-weeks postmenstrual age predicts 12-month cognitive outcomes in very preterm-born infants

Associations between malaria in pregnancy and neonatal neurological outcomes

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