Abstract 1116 Poster Session II, Sunday, 5/2 (poster 74)

Early prediction of developmental disabilities of very low birthweight (VLBW) infants is an important component of assessment. A number of functional and anatomical imaging tests have been developed in an effort to establish reliable methods that are minimally invasive. In the present study we compare neuroimaging and neurobehavioral data from VLBW infants with the long-term goal of determining the predictive value of these tests.

Methods: A population of 60 preterm infants with birthweight <1250 g and <30 weeks gestational age were assessed using the following methods. 1. Brain MR T1 and T2 weighted image sequences using 5 mm slices with 1 mm gap. MRIs were rated for hemorrhagic, nonhemorrhagic, or combined injury. 2. Neurobehavioral Assessment of the Preterm Infant (NAPI) which is a test of developmental maturity in the domains of scarf sign, popliteal angel, motor development and vigor, alertness and orientation, irritability and state regulation. Infants with scores within one standard deviation of the norm in all domains were scored as normal. 3. Spontaneous general movements analyzed from videorecordings are scored on the basis of the quality of movement; the sequence, fluency and character. 4. Bayley Infant Neurodevelopmental Screener (BINS). Infants in the low risk category were considered normal. All assessments were compressed to a binary scale representing either normal or suspect findings.

Results. 48% of our study group had a normal MRI. Our data, shown in the following table, indicate that at 36 weeks post conceptional age there was a 64% agreement between MRI and the NAPI and a 60% agreement between MRI and the analysis of GMS. Agreement between MRI at 36 weeks and GMS and BINS done between 3 and 4 months corrected age were 47% and 64% respectively. Agreement between MRI at 36 weeks PCA and BINS at 12 months corrected age shows a 75% agreement. (Table)

Table 1 No caption
Full size table

Conclusions: There was no statistically significant agreement by McNemar's test between the MRI and the other neurobehavioral tests (NAPI, GMs, BINS) at any of the ages studied. More numbers are needed before conclusive conclusions can be drawn from these studies. However the data suggest that functional manifestations of MRI findings may not be declared until later stages of development.