Neuroimaging and neurodevelopmental outcome in extremely preterm infants
Susan R Hintz, Patrick D Barnes, Dorothy Bulas, Thomas L Slovis, Neil N Finer, Lisa A Wrage, Abhik Das, Jon E Tyson, David K Stevenson, Waldemar A Carlo, Michele C Walsh, Abbot R Laptook, Bradley A Yoder, Krisa P Van Meurs, Roger G Faix, Wade Rich, Nancy S Newman, Helen Cheng, Roy J Heyne, Betty R Vohr, Michael J Acarregui, Yvonne E Vaucher, Athina Pappas, Myriam Peralta-Carcelen, Deanne E Wilson-Costello, Patricia W Evans, Ricki F Goldstein, Gary J Myers, Brenda B Poindexter, Elisabeth C McGowan, Ira Adams-Chapman, Janell Fuller, Rosemary D Higgins, SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, Alan H Jobe, Michael S Caplan, William Oh, Angelita M Hensman, Barbara Alksninis, Dawn Andrews, Kristen Angela, Susan Barnett, Bill Cashore, Melinda Caskey, Kim Francis, Dan Gingras, Katharine Johnson, Theresa M Leach, Bonnie E Stephens, Victoria E Watson, Michele C Walsh, Avroy A Fanaroff, Nancy S Newman, Bonnie S Siner, Arlene Zadell, Julie DiFiore, Monika Bhola, Harriet G Friedman, Gulgun Yalcinkaya, Ronald N Goldberg, C Michael Cotten, Patricia Ashley, Kathy J Auten, Kimberley A Fisher, Katherine A Foy, Sharon F Freedman, Kathryn E Gustafson, Melody B Lohmeyer, William F Malcolm, David K Wallace, Barbara J Stoll, Susie Buchter, Anthony J Piazza, David P Carlton, Sheena Carter, Sobha Fritz, Ellen C Hale, Amy K Hutchinson, Maureen Mulligan LaRossa, Stephanie Wilson Archer, Anna M Dusick, James A Lemons, Leslie D Wilson, Faithe Hamer, Ann B Cook, Dianne E Herron, Carolyn Lytle, Heike M Minnich, Mary Anne Berberich, Carol J Blaisdell, Dorothy B Gail, James P Kiley, Abhik Das, Marie G Gantz, Jamie E Newman, Betty K Hastings, Elizabeth M McClure, Jeanette O'Donnell Auman, Carolyn Petrie Huitema, Kenneth Poole, James W Pickett 2nd, Dennis Wallace, Kristin M Zaterka-Baxter, David K Stevenson, M Bethany Ball, Barbara Bentley, Elizabeth F Bruno, Maria Elena DeAnda, Anne M DeBattista, Jean G Kohn, Melinda S Proud, Renee P Pyle, Hali E Weiss, Ivan D Frantz 3rd, John M Fiascone, Anne Furey, Brenda L MacKinnon, Ellen Nylen, Ana Brussa, Cecelia Sibley, Waldemar A Carlo, Namasivayam Ambalavanan, Monica V Collins, Shirley S Cosby, Vivien A Phillips, Kirstin J Bailey, Fred J Biasini, Maria Hopkins, Kristen C Johnston, Sara Krzywanski, Kathleen G Nelson, Cryshelle S Patterson, Richard V Rector, Leslie Rodriguez, Amanda Soong, Sally Whitley, Sheree York, Neil N Finer, Maynard R Rasmussen, Paul R Wozniak, Wade Rich, Kathy Arnell, Rene Barbieri-Welge, Ayala Ben-Tall, Renee Bridge, Clarence Demetrio, Martha G Fuller, Elaine Ito, Meghan Lukasik, Deborah Pontillo, Donna Posin, Cheryl Runyan, Edward F Bell, John A Widness, Jonathan M Klein, Tarah T Colaizy, Karen J Johnson, Diane L Eastman, Shahnaz Duara, Charles R Bauer, Ruth Everett-Thomas, Maria Calejo, Alexis N Diaz, Silvia M Frade Eguaras, Andrea Garcia, Kasey Hamlin-Smith, Michelle Harwood Berkowits, Sylvia Hiriart-Fajardo, Elaine O Mathews, Helina Pierre, Paul Zlotnik, Arielle Riguard, Alexandra Stroerger, Kristi L Watterberg, Robin K Ohls, Julie Rohr, Conra Backstrom Lacy, Jean Lowe, Rebecca Montman, Sandra Brown, Nirupama Laroia, Dale L Phelps, Gary David Markowitz, Linda J Reubens, Diane Hust, Lisa Augostino, Julie Babish Johnson, Erica Burnell, Harris Gelbard, Rosemary L Jensen, Emily Kushner, Joan Merzbach, Jonathan Mink, Carlos Torres, David Wang, Kelley Yost, Pablo J Sánchez, Charles R Rosenfeld, Walid A Salhab, Sally S Adams, James Allen, Laura Grau, Alicia Guzman, Gaynelle Hensley, Elizabeth T Heyne, Melissa H Lepps, Linda A Madden, Melissa Martin, Nancy A Miller, Janet S Morgan, Araceli Solis, Lizette E Torres, Catherine Twell Boatman, Diana M Vasil, Kerry Wilder, Kathleen A Kennedy, Jon E Tyson, Nora I Alaniz, Beverly Foley Harris, Charles Green, Margarita Jiminez, Anna E Lis, Sarah Martin, Georgia E McDavid, Brenda H Morris, Margaret L Poundstone, Stacy Reddoch, Saba Siddiki, Patti L Pierce Tate, Laura L Whitely, Sharon L Wright, Bradley A Yoder, Roger G Faix, Shawna Baker, Karie Bird, Anna E Bullwinkle, Jill Burnett, Laura Cole, Karen A Osborne, Cynthia Spencer, R Edison Steele, Michael Steffen, Kimberlee Weaver-Lewis, T Michael O'Shea, Robert G Dillard, Lisa K Washburn, Nancy J Peters, Barbara G Jackson, Korinne Chiu, Deborah Evans Allred, Donald J Goldstein, Raquel Halfond, Carroll Peterson, Ellen L Waldrep, Cherrie D Welch, Melissa Whalen Morris, Gail Wiley Hounshell, Seetha Shankaran, Beena G Sood, Rebecca Bara, Elizabeth Billian, Laura A Goldston, Mary Johnson, Susan R Hintz, Patrick D Barnes, Dorothy Bulas, Thomas L Slovis, Neil N Finer, Lisa A Wrage, Abhik Das, Jon E Tyson, David K Stevenson, Waldemar A Carlo, Michele C Walsh, Abbot R Laptook, Bradley A Yoder, Krisa P Van Meurs, Roger G Faix, Wade Rich, Nancy S Newman, Helen Cheng, Roy J Heyne, Betty R Vohr, Michael J Acarregui, Yvonne E Vaucher, Athina Pappas, Myriam Peralta-Carcelen, Deanne E Wilson-Costello, Patricia W Evans, Ricki F Goldstein, Gary J Myers, Brenda B Poindexter, Elisabeth C McGowan, Ira Adams-Chapman, Janell Fuller, Rosemary D Higgins, SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, Alan H Jobe, Michael S Caplan, William Oh, Angelita M Hensman, Barbara Alksninis, Dawn Andrews, Kristen Angela, Susan Barnett, Bill Cashore, Melinda Caskey, Kim Francis, Dan Gingras, Katharine Johnson, Theresa M Leach, Bonnie E Stephens, Victoria E Watson, Michele C Walsh, Avroy A Fanaroff, Nancy S Newman, Bonnie S Siner, Arlene Zadell, Julie DiFiore, Monika Bhola, Harriet G Friedman, Gulgun Yalcinkaya, Ronald N Goldberg, C Michael Cotten, Patricia Ashley, Kathy J Auten, Kimberley A Fisher, Katherine A Foy, Sharon F Freedman, Kathryn E Gustafson, Melody B Lohmeyer, William F Malcolm, David K Wallace, Barbara J Stoll, Susie Buchter, Anthony J Piazza, David P Carlton, Sheena Carter, Sobha Fritz, Ellen C Hale, Amy K Hutchinson, Maureen Mulligan LaRossa, Stephanie Wilson Archer, Anna M Dusick, James A Lemons, Leslie D Wilson, Faithe Hamer, Ann B Cook, Dianne E Herron, Carolyn Lytle, Heike M Minnich, Mary Anne Berberich, Carol J Blaisdell, Dorothy B Gail, James P Kiley, Abhik Das, Marie G Gantz, Jamie E Newman, Betty K Hastings, Elizabeth M McClure, Jeanette O'Donnell Auman, Carolyn Petrie Huitema, Kenneth Poole, James W Pickett 2nd, Dennis Wallace, Kristin M Zaterka-Baxter, David K Stevenson, M Bethany Ball, Barbara Bentley, Elizabeth F Bruno, Maria Elena DeAnda, Anne M DeBattista, Jean G Kohn, Melinda S Proud, Renee P Pyle, Hali E Weiss, Ivan D Frantz 3rd, John M Fiascone, Anne Furey, Brenda L MacKinnon, Ellen Nylen, Ana Brussa, Cecelia Sibley, Waldemar A Carlo, Namasivayam Ambalavanan, Monica V Collins, Shirley S Cosby, Vivien A Phillips, Kirstin J Bailey, Fred J Biasini, Maria Hopkins, Kristen C Johnston, Sara Krzywanski, Kathleen G Nelson, Cryshelle S Patterson, Richard V Rector, Leslie Rodriguez, Amanda Soong, Sally Whitley, Sheree York, Neil N Finer, Maynard R Rasmussen, Paul R Wozniak, Wade Rich, Kathy Arnell, Rene Barbieri-Welge, Ayala Ben-Tall, Renee Bridge, Clarence Demetrio, Martha G Fuller, Elaine Ito, Meghan Lukasik, Deborah Pontillo, Donna Posin, Cheryl Runyan, Edward F Bell, John A Widness, Jonathan M Klein, Tarah T Colaizy, Karen J Johnson, Diane L Eastman, Shahnaz Duara, Charles R Bauer, Ruth Everett-Thomas, Maria Calejo, Alexis N Diaz, Silvia M Frade Eguaras, Andrea Garcia, Kasey Hamlin-Smith, Michelle Harwood Berkowits, Sylvia Hiriart-Fajardo, Elaine O Mathews, Helina Pierre, Paul Zlotnik, Arielle Riguard, Alexandra Stroerger, Kristi L Watterberg, Robin K Ohls, Julie Rohr, Conra Backstrom Lacy, Jean Lowe, Rebecca Montman, Sandra Brown, Nirupama Laroia, Dale L Phelps, Gary David Markowitz, Linda J Reubens, Diane Hust, Lisa Augostino, Julie Babish Johnson, Erica Burnell, Harris Gelbard, Rosemary L Jensen, Emily Kushner, Joan Merzbach, Jonathan Mink, Carlos Torres, David Wang, Kelley Yost, Pablo J Sánchez, Charles R Rosenfeld, Walid A Salhab, Sally S Adams, James Allen, Laura Grau, Alicia Guzman, Gaynelle Hensley, Elizabeth T Heyne, Melissa H Lepps, Linda A Madden, Melissa Martin, Nancy A Miller, Janet S Morgan, Araceli Solis, Lizette E Torres, Catherine Twell Boatman, Diana M Vasil, Kerry Wilder, Kathleen A Kennedy, Jon E Tyson, Nora I Alaniz, Beverly Foley Harris, Charles Green, Margarita Jiminez, Anna E Lis, Sarah Martin, Georgia E McDavid, Brenda H Morris, Margaret L Poundstone, Stacy Reddoch, Saba Siddiki, Patti L Pierce Tate, Laura L Whitely, Sharon L Wright, Bradley A Yoder, Roger G Faix, Shawna Baker, Karie Bird, Anna E Bullwinkle, Jill Burnett, Laura Cole, Karen A Osborne, Cynthia Spencer, R Edison Steele, Michael Steffen, Kimberlee Weaver-Lewis, T Michael O'Shea, Robert G Dillard, Lisa K Washburn, Nancy J Peters, Barbara G Jackson, Korinne Chiu, Deborah Evans Allred, Donald J Goldstein, Raquel Halfond, Carroll Peterson, Ellen L Waldrep, Cherrie D Welch, Melissa Whalen Morris, Gail Wiley Hounshell, Seetha Shankaran, Beena G Sood, Rebecca Bara, Elizabeth Billian, Laura A Goldston, Mary Johnson
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.
Copyright © 2015 by the American Academy of Pediatrics.
Source: PubMed