Long-term neurodevelopmental outcome of preterm children with unilateral cerebral lesions diagnosed by neonatal ultrasound
Department of Paediatrics, University College London Medical School, Rayne Institute, University Street, London WC1E 6JJ, UK. Early Human Development
(Impact Factor: 1.79).
10/2006; 82(10):655-61. DOI: 10.1016/j.earlhumdev.2005.12.011
Little information is available on long-term neurodevelopmental outcome of preterm infants with unilateral cerebral lesions detected by neonatal cranial ultrasound. This study aims to investigate the long-term outcome in a cohort of very preterm infants with unilateral cerebral lesions acquired in the perinatal period.
A prospective cohort study of 668 preterm infants (<33 weeks gestation; birth years 1985-1991) at a single tertiary perinatal centre in the UK. All infants had serial cranial ultrasound examination in the neonatal period. Outcome was assessed at age 8 years with the Wechsler Intelligence Scales for Children (WISC-R), Test of Visuo-motor Integration (VMI) and the Test of Motor Impairment (TOMI).
Of the 668 infants, 369 infants had normal ultrasound scans. Two hundred and ninety nine children had bilateral parenchymal or non-parenchymal lesions (57 left-sided, 41 right-sided, 201 bilateral). Five hundred and thirty four (79%) children attended follow-up at age 8 years. Mean Full Scale IQ (FSIQ) was 101 (SD+/-16), 93 (SD+/-17), 102 (SD+/-17) and 91 (SD+/-21) for normal, left-sided, right-sided and bilateral lesion groups respectively. In all groups verbal IQ (VIQ) was higher than performance IQ (PIQ). Scores of FSIQ, VIQ and PIQ, VMI and TOMI were significantly different between the groups. After exclusion of children with parenchymal lesions, however, the difference was only significant for the TOMI scores. In all tests, children with left-sided lesions performed poorer than children with right-sided lesions.
In this cohort of preterm infants with unilateral cerebral lesions, verbal function was preserved over non-verbal function independently of the side of lesion. Furthermore, the results suggest that the neurodevelopmental outcome of children with left-sided lesions is less favourable than that of children with right-sided lesions.
Available from: Malgorzata Lipowska
- "At the same time, preterm children were found to have signifi cantly lower scores on two subtests of the Wechsler Intelligence Scale: Vocabulary and Puzzles. Similar results have been reported by Kennell & Marshall (1982), Korzon et al. (1998), Bowen et al. (2002), Bohm et al. (2002), and Vollmer et al. (2006). The research done by Wolke et al. (2008) regarding the language-related problems of children born very prematurely indicated that, although these children have a signifi cantly lower level of linguistic functioning, this is rather the effect of a global cognitive defi cit, and SLI should not be diagnosed in these cases. "
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ABSTRACT: The aim of the study was verifying, whether speech development is conditioned by a preterm birth, multiple pregnancy or pregnancy complicated with TTTS. We examined 52 preterm children, 15 of which were born after a single pregnancy and 42 after a multiple pregnancy. 23 children came from a pregnancy complicated by TTTS. The average age of the subjects was 32.5 months (SD=5.54). The research methods used in our study were as follows: analysis of medical documentation, a structured clinical interview and psychological conversation. Speech development of a child was assessed using BSID-III. An analysis of the results we obtained showed that there was a lower level of EC in the TTTS children in comparison to multiple-birth children without TTTS and single-birth children. We also found statistically signifi cant relations between the EC scores and gender, age at the time of testing, disability, gestational age, birth weight.
Available from: mospace.umsystem.edu
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