May 1993

Developmental Outcome of Preterm Infants With Transient Neuromotor Abnormalities

Author Affiliations

From the Departments of Pediatrics (Ms D'Eugenio and Drs Slagle and Gross) and Psychiatry (Ms Mettelman), State University of New York Health Science Center, Syracuse.

Am J Dis Child. 1993;147(5):570-574. doi:10.1001/archpedi.1993.02160290076030

• Objective.  —To determine the relationship between transiently abnormal neurologic findings in preterm infants and subsequent cognitive outcome at 4 years of age.

Design.  —Prospective 4-year follow-up.

Setting.  —Regional perinatal center in Syracuse, NY.

Participants.  —One hundred thirty-one of 135 consecutively born infants of no more than 32 weeks of gestational age; 98% followed up from birth to 4 years of age.

Interventions.  —None.

Measurements and Main Results.  —Based on neuromotor evaluations performed at 6 and 15 months of age, two groups of infants were identified. One group had abnormal neurologic findings at 6 months of age that had resolved by 15 months of age (transiently abnormal group). The other group had normal neuromotor findings at both 6 and 15 months of age (normal group). The transiently abnormal group had significantly poorer scores on the Bayley Mental scale at 6 months of age 90±15 vs 108±10; P<.001), 15 months (91±21 vs 105±12; P<.001), and 24 months (91 ±19 vs 101 ±17; P<.001). However, at 4 years of age, cognitive performance on the McCarthy Scales was similar for the transiently abnormal and normal groups (General Cognitive index, 93±13 and 95±14, respectively). The incidence of poor cognitive outcome (Cognitive index <84) decreased from 39% at 2 years of age to 18% at 4 years of age in the group with a history of transient neurologic abnormalities but remained unchanged (16% to 18%) in the normal group.

Conclusion.  —Early neurologic abnormalities that are transient did not predict cognitive delays at 4 years of age in preterm infants.(AJDC. 1993;147:570-574)