Preterm neuroimaging and school-age cognitive outcomes

Susan R. Hintz, Betty R. Vohr, Carla M. Bann, H. Gerry Taylor, Abhik Das, Kathryn E. Gustafson, Kimberly Yolton, Victoria E. Watson, Jean Lowe, Maria Elena De Anda, M. Bethany Ball, Neil N. Finer, Krisa P. Van Meurs, Seetha Shankaran, Athina Pappas, Patrick D. Barnes, Dorothy Bulas, Jamie E. Newman, Deanne E. Wilson-Costello, Roy J. HeyneHeidi M. Harmon, Myriam Peralta-Carcelen, Ira Adams-Chapman, Andrea Freeman Duncan, Janell Fuller, Yvonne E. Vaucher, Tarah T. Colaizy, Sarah Winter, Elisabeth C. McGowan, Ricki F. Goldstein, Rosemary D. Higgins, Alan H. Jobe, Michael S. Caplan, Richard A. Polin, Abbot R. Laptook, Angelita M. Hensman, Elisa Vieira, Emilee Little, Katharine Johnson, Barbara Alksninis, Mary Lenore Keszler, Andrea M. Knoll, Theresa M. Leach, Michele C. Walsh, Avroy A. Fanaroff, Allison Payne, Nancy S. Newman, Bonnie S. Siner, Arlene Zadell, Julie Di Fiore, 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, Melody B. Lohmeyer, William F. Malcolm, David K. Wallace, David P. Carlton, Barbara J. Stoll, Susie Buchter, Anthony J. Piazza, Sheena Carter, Sobha Fritz, Ellen C. Hale, Amy K. Hutchinson, Maureen Mulligan La Rossa, Yvonne Loggins, Diane Bottcher, Stephanie Wilson Archer, Brenda B. Poindexter, Gregory M. Sokol, Lu Ann Papile, Abbey C. Hines, Leslie D. Wilson, Dianne E. Herron, Lucy Smiley, Kathleen A. Kennedy, Jon E. Tyson, Allison G. Dempsey, Janice John, Patrick M. Jones, M. Layne Lillie, Saba Siddiki, Daniel K. Sperry, Mary Anne Berberich, Carol J. Blaisdell, Dorothy B. Gail, James P. Kiley, Dennis Wallace, Marie G. Gantz, Jeanette O.Donnell Auman, Jane A. Hammond, W. Kenneth Poole, David K. Stevenson, Gabrielle T. Goodlin, Ivan D. Frantz, 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, Kristy Domanovich, Sally Whitley, Leigh Ann Smith, Carin R. Kiser, Donna Garey, Maynard R. Rasmussen, Paul R. Wozniak, Martha G. Fuller, Natacha Akshoomoff, Wade Rich, Kathy Arnell, Renee Bridge, Edward F. Bell, John A. Widness, Jonathan M. Klein, Karen J. Johnson, Michael J. Acarregui, Diane L. Eastman, Tammy L.V. Wilgenbusch, Kristi L. Watterberg, Robin K. Ohls, Julie Rohr, Conra Backstrom Lacy, Rebecca Montman, Sandra Brown, Pablo J. Sánchez, Charles R. Rosenfeld, Walid A. Salhab, Luc Brion, Sally S. Adams, James Allen, Laura Grau, Alicia Guzman, Gaynelle Hensley, Elizabeth T. Heyne, Jackie F. Hickman, Melissa H. Leps, Linda A. Madden, Melissa Martin, Nancy A. Miller, Janet S. Morgan, Araceli Solis, Lizette E. Lee, Catherine Twell Boatman, Diana M. Vasil, Bradley A. Yoder, Roger G. Faix, Shawna Baker, Karen A. Osborne, Carrie A. Rau, Sean Cunningham, Ariel Ford, Beena G. Sood, Rebecca Bara, Thomas L. Slovis, Elizabeth Billian, Laura A. Goldston, Mary Johnson, Maureen Hack

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Abstract

BACKGROUND AND OBJECTIVES: Children born extremely preterm are at risk for cognitive difficulties and disability. The relative prognostic value of neonatal brain MRI and cranial ultrasound (CUS) for school-age outcomes remains unclear. Our objectives were to relate near-term conventional brain MRI and early and late CUS to cognitive impairment and disability at 6 to 7 years among children born extremely preterm and assess prognostic value. METHODS: A prospective study of adverse early and late CUS and near-term conventional MRI findings to predict outcomes at 6 to 7 years including a full-scale IQ (FSIQ) <70 and disability (FSIQ <70, moderate-to-severe cerebral palsy, or severe vision or hearing impairment) in a subgroup of Surfactant Positive Airway Pressure and Pulse Oximetry Randomized Trial enrollees. Stepwise logistic regression evaluated associations of neuroimaging with outcomes, adjusting for perinatal-neonatal factors. RESULTS: A total of 386 children had follow-up. In unadjusted analyses, severity of white matter abnormality and cerebellar lesions on MRI and adverse CUS findings were associated with outcomes. In full regression models, both adverse late CUS findings (odds ratio [OR] 27.9; 95% confidence interval [CI] 6.0-129) and significant cerebellar lesions on MRI (OR 2.71; 95% CI 1.1-6.7) remained associated with disability, but only adverse late CUS findings (OR 20.1; 95% CI 3.6-111) were associated with FSIQ <70. Predictive accuracy of stepwise models was not substantially improved with the addition of neuroimaging. CONCLUSIONS: Severe but rare adverse late CUS findings were most strongly associated with cognitive impairment and disability at school age, and significant cerebellar lesions on MRI were associated with disability. Near-term conventional MRI did not substantively enhance prediction of severe early school-age outcomes.

Original languageEnglish (US)
Article numbere20174058
JournalPediatrics
Volume142
Issue number1
DOIs
StatePublished - Jul 2018

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Hintz, S. R., Vohr, B. R., Bann, C. M., Taylor, H. G., Das, A., Gustafson, K. E., Yolton, K., Watson, V. E., Lowe, J., De Anda, M. E., Ball, M. B., Finer, N. N., Van Meurs, K. P., Shankaran, S., Pappas, A., Barnes, P. D., Bulas, D., Newman, J. E., Wilson-Costello, D. E., ... Hack, M. (2018). Preterm neuroimaging and school-age cognitive outcomes. Pediatrics, 142(1), [e20174058]. https://doi.org/10.1542/peds.2017-4058