Abstract 2044 Poster Session II, Sunday, 5/2 (poster 215)

Objective: We evaluated whether a detailed neurological examination at three months of age could predict later neuromotor abnormalities in a population of term infants with perinatal depression.

Methods: In a prospective cohort study of term infants with perinatal depression, infants had a blinded neurological examination at 3 and 12 months of age. Using a new neuromotor scoring system, infants received a neuromotor score (NMS), ranging from 0 (normal) to 5 (spastic quadriplegia). Overall neurological status was also expressed as normal, abnormal or unclear. The scores at three months were correlated with those of the 12 month examination. Results: 74 infants have been studied to date. By one year, 9 were lost to follow up and of the 65 infants examined, 55.4% had neurologic abnormalities and 44.4% were normal. NMS at 3 months correlated strongly with NMS at one year (r=0.76; p<0.0001) and overall neurological status at one year (p=0.002). A NMS of 4 or 5 at three months identified all infants with severe neuromotor abnormality at one year. Infants with a 3 month NMS greater than 3 and a history of neonatal seizures showed a significantly increased risk of subsequent neurologic abnormalities at one year (p=0.0001). 18 infants exhibited transient abnormalities, with a normal examination at 12 months of age following a mildly abnormal 3 month exam (median NMS=2). Conclusions: Using the neuromotor score, early neurologic examination was highly correlated with neuromotor outcome in term infants with perinatal depression. A subgroup of infants had transient, mild abnormalities. These findings suggest that in high-risk term infants, useful information regarding neuromotor prognosis can be obtained as early as three months of age.