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. Heyne; Heidi 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

doi:10.1542/peds.2017-4058

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

Research output: Contribution to journal › Article › peer-review

55 Scopus citations

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 language	English (US)
Article number	e20174058
Journal	Pediatrics
Volume	142
Issue number	1
DOIs	https://doi.org/10.1542/peds.2017-4058
State	Published - Jul 2018

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

Access to Document

10.1542/peds.2017-4058

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), Article e20174058. https://doi.org/10.1542/peds.2017-4058

Hintz, SR, Vohr, BR, Bann, CM, Taylor, HG, Das, A, Gustafson, KE, Yolton, K, Watson, VE, Lowe, J, De Anda, ME, Ball, MB, Finer, NN, Van Meurs, KP, Shankaran, S, Pappas, A, Barnes, PD, Bulas, D, Newman, JE, Wilson-Costello, DE, Heyne, RJ, Harmon, HM, Peralta-Carcelen, M, Adams-Chapman, I, Duncan, AF, Fuller, J, Vaucher, YE, Colaizy, TT, Winter, S, McGowan, EC, Goldstein, RF, Higgins, RD, Jobe, AH, Caplan, MS, Polin, RA, Laptook, AR, Hensman, AM, Vieira, E, Little, E, Johnson, K, Alksninis, B, Keszler, ML, Knoll, AM, Leach, TM, Walsh, MC, Fanaroff, AA, Payne, A, Newman, NS, Siner, BS, Zadell, A, Di Fiore, J, Bhola, M, Friedman, HG, Yalcinkaya, G, Goldberg, RN, Cotten, CM, Ashley, P, Auten, KJ, Fisher, KA, Foy, KA, Freedman, SF, Lohmeyer, MB, Malcolm, WF, Wallace, DK, Carlton, DP, Stoll, BJ, Buchter, S, Piazza, AJ, Carter, S, Fritz, S, Hale, EC, Hutchinson, AK, La Rossa, MM, Loggins, Y, Bottcher, D, Archer, SW, Poindexter, BB, Sokol, GM, Papile, LA, Hines, AC, Wilson, LD, Herron, DE, Smiley, L, Kennedy, KA, Tyson, JE, Dempsey, AG, John, J, Jones, PM, Lillie, ML, Siddiki, S, Sperry, DK, Berberich, MA, Blaisdell, CJ, Gail, DB, Kiley, JP, Wallace, D, Gantz, MG, Auman, JOD, Hammond, JA, Poole, WK, Stevenson, DK, Goodlin, GT, Frantz, ID, Fiascone, JM, Furey, A, MacKinnon, BL, Nylen, E, Brussa, A, Sibley, C, Carlo, WA, Ambalavanan, N, Collins, MV, Cosby, SS, Phillips, VA, Domanovich, K, Whitley, S, Smith, LA, Kiser, CR, Garey, D, Rasmussen, MR, Wozniak, PR, Fuller, MG, Akshoomoff, N, Rich, W, Arnell, K, Bridge, R, Bell, EF, Widness, JA, Klein, JM, Johnson, KJ, Acarregui, MJ, Eastman, DL, Wilgenbusch, TLV, Watterberg, KL, Ohls, RK, Rohr, J, Lacy, CB, Montman, R, Brown, S, Sánchez, PJ, Rosenfeld, CR, Salhab, WA, Brion, L, Adams, SS, Allen, J, Grau, L, Guzman, A, Hensley, G, Heyne, ET, Hickman, JF, Leps, MH, Madden, LA, Martin, M, Miller, NA, Morgan, JS, Solis, A, Lee, LE, Boatman, CT, Vasil, DM, Yoder, BA, Faix, RG, Baker, S, Osborne, KA, Rau, CA, Cunningham, S, Ford, A, Sood, BG, Bara, R, Slovis, TL, Billian, E, Goldston, LA, Johnson, M & Hack, M 2018, 'Preterm neuroimaging and school-age cognitive outcomes', Pediatrics, vol. 142, no. 1, e20174058. https://doi.org/10.1542/peds.2017-4058

@article{aaa9a34541f64b23ab90514646ed92eb,

title = "Preterm neuroimaging and school-age cognitive outcomes",

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.",

author = "Hintz, {Susan R.} and Vohr, {Betty R.} and Bann, {Carla M.} and Taylor, {H. Gerry} and Abhik Das and Gustafson, {Kathryn E.} and Kimberly Yolton and Watson, {Victoria E.} and Jean Lowe and {De Anda}, {Maria Elena} and Ball, {M. Bethany} and Finer, {Neil N.} and {Van Meurs}, {Krisa P.} and Seetha Shankaran and Athina Pappas and Barnes, {Patrick D.} and Dorothy Bulas and Newman, {Jamie E.} and Wilson-Costello, {Deanne E.} and Heyne, {Roy J.} and Harmon, {Heidi M.} and Myriam Peralta-Carcelen and Ira Adams-Chapman and Duncan, {Andrea Freeman} and Janell Fuller and Vaucher, {Yvonne E.} and Colaizy, {Tarah T.} and Sarah Winter and McGowan, {Elisabeth C.} and Goldstein, {Ricki F.} and Higgins, {Rosemary D.} and Jobe, {Alan H.} and Caplan, {Michael S.} and Polin, {Richard A.} and Laptook, {Abbot R.} and Hensman, {Angelita M.} and Elisa Vieira and Emilee Little and Katharine Johnson and Barbara Alksninis and Keszler, {Mary Lenore} and Knoll, {Andrea M.} and Leach, {Theresa M.} and Walsh, {Michele C.} and Fanaroff, {Avroy A.} and Allison Payne and Newman, {Nancy S.} and Siner, {Bonnie S.} and Arlene Zadell and {Di Fiore}, Julie and Monika Bhola and Friedman, {Harriet G.} and Gulgun Yalcinkaya and Goldberg, {Ronald N.} and Cotten, {C. Michael} and Patricia Ashley and Auten, {Kathy J.} and Fisher, {Kimberley A.} and Foy, {Katherine A.} and Freedman, {Sharon F.} and Lohmeyer, {Melody B.} and Malcolm, {William F.} and Wallace, {David K.} and Carlton, {David P.} and Stoll, {Barbara J.} and Susie Buchter and Piazza, {Anthony J.} and Sheena Carter and Sobha Fritz and Hale, {Ellen C.} and Hutchinson, {Amy K.} and {La Rossa}, {Maureen Mulligan} and Yvonne Loggins and Diane Bottcher and Archer, {Stephanie Wilson} and Poindexter, {Brenda B.} and Sokol, {Gregory M.} and Papile, {Lu Ann} and Hines, {Abbey C.} and Wilson, {Leslie D.} and Herron, {Dianne E.} and Lucy Smiley and Kennedy, {Kathleen A.} and Tyson, {Jon E.} and Dempsey, {Allison G.} and Janice John and Jones, {Patrick M.} and Lillie, {M. Layne} and Saba Siddiki and Sperry, {Daniel K.} and Berberich, {Mary Anne} and Blaisdell, {Carol J.} and Gail, {Dorothy B.} and Kiley, {James P.} and Dennis Wallace and Gantz, {Marie G.} and Auman, {Jeanette O.Donnell} and Hammond, {Jane A.} and Poole, {W. Kenneth} and Stevenson, {David K.} and Goodlin, {Gabrielle T.} and Frantz, {Ivan D.} and Fiascone, {John M.} and Anne Furey and MacKinnon, {Brenda L.} and Ellen Nylen and Ana Brussa and Cecelia Sibley and Carlo, {Waldemar A.} and Namasivayam Ambalavanan and Collins, {Monica V.} and Cosby, {Shirley S.} and Phillips, {Vivien A.} and Kristy Domanovich and Sally Whitley and Smith, {Leigh Ann} and Kiser, {Carin R.} and Donna Garey and Rasmussen, {Maynard R.} and Wozniak, {Paul R.} and Fuller, {Martha G.} and Natacha Akshoomoff and Wade Rich and Kathy Arnell and Renee Bridge and Bell, {Edward F.} and Widness, {John A.} and Klein, {Jonathan M.} and Johnson, {Karen J.} and Acarregui, {Michael J.} and Eastman, {Diane L.} and Wilgenbusch, {Tammy L.V.} and Watterberg, {Kristi L.} and Ohls, {Robin K.} and Julie Rohr and Lacy, {Conra Backstrom} and Rebecca Montman and Sandra Brown and S{\'a}nchez, {Pablo J.} and Rosenfeld, {Charles R.} and Salhab, {Walid A.} and Luc Brion and Adams, {Sally S.} and James Allen and Laura Grau and Alicia Guzman and Gaynelle Hensley and Heyne, {Elizabeth T.} and Hickman, {Jackie F.} and Leps, {Melissa H.} and Madden, {Linda A.} and Melissa Martin and Miller, {Nancy A.} and Morgan, {Janet S.} and Araceli Solis and Lee, {Lizette E.} and Boatman, {Catherine Twell} and Vasil, {Diana M.} and Yoder, {Bradley A.} and Faix, {Roger G.} and Shawna Baker and Osborne, {Karen A.} and Rau, {Carrie A.} and Sean Cunningham and Ariel Ford and Sood, {Beena G.} and Rebecca Bara and Slovis, {Thomas L.} and Elizabeth Billian and Goldston, {Laura A.} and Mary Johnson and Maureen Hack",

year = "2018",

month = jul,

doi = "10.1542/peds.2017-4058",

language = "English (US)",

volume = "142",

journal = "Pediatrics",

issn = "0031-4005",

publisher = "American Academy of Pediatrics",

number = "1",

}

TY - JOUR

T1 - Preterm neuroimaging and school-age cognitive outcomes

AU - Hintz, Susan R.

AU - Vohr, Betty R.

AU - Bann, Carla M.

AU - Taylor, H. Gerry

AU - Das, Abhik

AU - Gustafson, Kathryn E.

AU - Yolton, Kimberly

AU - Watson, Victoria E.

AU - Lowe, Jean

AU - De Anda, Maria Elena

AU - Ball, M. Bethany

AU - Finer, Neil N.

AU - Van Meurs, Krisa P.

AU - Shankaran, Seetha

AU - Pappas, Athina

AU - Barnes, Patrick D.

AU - Bulas, Dorothy

AU - Newman, Jamie E.

AU - Wilson-Costello, Deanne E.

AU - Heyne, Roy J.

AU - Harmon, Heidi M.

AU - Peralta-Carcelen, Myriam

AU - Adams-Chapman, Ira

AU - Duncan, Andrea Freeman

AU - Fuller, Janell

AU - Vaucher, Yvonne E.

AU - Colaizy, Tarah T.

AU - Winter, Sarah

AU - McGowan, Elisabeth C.

AU - Goldstein, Ricki F.

AU - Higgins, Rosemary D.

AU - Jobe, Alan H.

AU - Caplan, Michael S.

AU - Polin, Richard A.

AU - Laptook, Abbot R.

AU - Hensman, Angelita M.

AU - Vieira, Elisa

AU - Little, Emilee

AU - Johnson, Katharine

AU - Alksninis, Barbara

AU - Keszler, Mary Lenore

AU - Knoll, Andrea M.

AU - Leach, Theresa M.

AU - Walsh, Michele C.

AU - Fanaroff, Avroy A.

AU - Payne, Allison

AU - Newman, Nancy S.

AU - Siner, Bonnie S.

AU - Zadell, Arlene

AU - Di Fiore, Julie

AU - Bhola, Monika

AU - Friedman, Harriet G.

AU - Yalcinkaya, Gulgun

AU - Goldberg, Ronald N.

AU - Cotten, C. Michael

AU - Ashley, Patricia

AU - Auten, Kathy J.

AU - Fisher, Kimberley A.

AU - Foy, Katherine A.

AU - Freedman, Sharon F.

AU - Lohmeyer, Melody B.

AU - Malcolm, William F.

AU - Wallace, David K.

AU - Carlton, David P.

AU - Stoll, Barbara J.

AU - Buchter, Susie

AU - Piazza, Anthony J.

AU - Carter, Sheena

AU - Fritz, Sobha

AU - Hale, Ellen C.

AU - Hutchinson, Amy K.

AU - La Rossa, Maureen Mulligan

AU - Loggins, Yvonne

AU - Bottcher, Diane

AU - Archer, Stephanie Wilson

AU - Poindexter, Brenda B.

AU - Sokol, Gregory M.

AU - Papile, Lu Ann

AU - Hines, Abbey C.

AU - Wilson, Leslie D.

AU - Herron, Dianne E.

AU - Smiley, Lucy

AU - Kennedy, Kathleen A.

AU - Tyson, Jon E.

AU - Dempsey, Allison G.

AU - John, Janice

AU - Jones, Patrick M.

AU - Lillie, M. Layne

AU - Siddiki, Saba

AU - Sperry, Daniel K.

AU - Berberich, Mary Anne

AU - Blaisdell, Carol J.

AU - Gail, Dorothy B.

AU - Kiley, James P.

AU - Wallace, Dennis

AU - Gantz, Marie G.

AU - Auman, Jeanette O.Donnell

AU - Hammond, Jane A.

AU - Poole, W. Kenneth

AU - Stevenson, David K.

AU - Goodlin, Gabrielle T.

AU - Frantz, Ivan D.

AU - Fiascone, John M.

AU - Furey, Anne

AU - MacKinnon, Brenda L.

AU - Nylen, Ellen

AU - Brussa, Ana

AU - Sibley, Cecelia

AU - Carlo, Waldemar A.

AU - Ambalavanan, Namasivayam

AU - Collins, Monica V.

AU - Cosby, Shirley S.

AU - Phillips, Vivien A.

AU - Domanovich, Kristy

AU - Whitley, Sally

AU - Smith, Leigh Ann

AU - Kiser, Carin R.

AU - Garey, Donna

AU - Rasmussen, Maynard R.

AU - Wozniak, Paul R.

AU - Fuller, Martha G.

AU - Akshoomoff, Natacha

AU - Rich, Wade

AU - Arnell, Kathy

AU - Bridge, Renee

AU - Bell, Edward F.

AU - Widness, John A.

AU - Klein, Jonathan M.

AU - Johnson, Karen J.

AU - Acarregui, Michael J.

AU - Eastman, Diane L.

AU - Wilgenbusch, Tammy L.V.

AU - Watterberg, Kristi L.

AU - Ohls, Robin K.

AU - Rohr, Julie

AU - Lacy, Conra Backstrom

AU - Montman, Rebecca

AU - Brown, Sandra

AU - Sánchez, Pablo J.

AU - Rosenfeld, Charles R.

AU - Salhab, Walid A.

AU - Brion, Luc

AU - Adams, Sally S.

AU - Allen, James

AU - Grau, Laura

AU - Guzman, Alicia

AU - Hensley, Gaynelle

AU - Heyne, Elizabeth T.

AU - Hickman, Jackie F.

AU - Leps, Melissa H.

AU - Madden, Linda A.

AU - Martin, Melissa

AU - Miller, Nancy A.

AU - Morgan, Janet S.

AU - Solis, Araceli

AU - Lee, Lizette E.

AU - Boatman, Catherine Twell

AU - Vasil, Diana M.

AU - Yoder, Bradley A.

AU - Faix, Roger G.

AU - Baker, Shawna

AU - Osborne, Karen A.

AU - Rau, Carrie A.

AU - Cunningham, Sean

AU - Ford, Ariel

AU - Sood, Beena G.

AU - Bara, Rebecca

AU - Slovis, Thomas L.

AU - Billian, Elizabeth

AU - Goldston, Laura A.

AU - Johnson, Mary

AU - Hack, Maureen

PY - 2018/7

Y1 - 2018/7

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85049554211&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85049554211&partnerID=8YFLogxK

U2 - 10.1542/peds.2017-4058

DO - 10.1542/peds.2017-4058

M3 - Article

C2 - 29945955

AN - SCOPUS:85049554211

SN - 0031-4005

VL - 142

JO - Pediatrics

JF - Pediatrics

IS - 1

M1 - e20174058

ER -

Preterm neuroimaging and school-age cognitive outcomes

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this