The assessment of spontaneous general movements (GM) early in life can be predictive of cerebral palsy (CP) which is usually diagnosed later than one year. Traditionally, assessment of the neonate has been based on neurological assessment including reflexes and muscle tone and a functional assessment. In this study we used the Bayley Infant Neurodevelopmental Screener (BINS). The Neurobehavioral Assessment of the Preterm Infant (NAPI) is a measure of relative maturity specifically developed for preterm infants. Currently there is interest in using neuroimaging techniques to screen for intracranial ischemic and hemorrhagic damage in order to identify preterm infants that are at risk for CP. In this study we compared the neuroimaging findings of very low birth weight preterm infants (< 1250 grams and < 30 weeks gestational age) as seen at MR examination performed at 36 weeks post conceptional age (PCA) with the NAPI and GM assessment evlauated in the same week. A repeat GM assessment was made at 3 months corrected age and the BINS was administered at 4 and 12 months corrected age. Preliminary analysis entailed a comparison of MR imaging findings and neurobehavioral assessments at 36 weeks PCA and at 4 and 12 months corrected age with the null hypothesis that the portion of subjects with positive findings were the same for both studies: that is the percentage of abnormal infants with neurologic abnormalities was the same as the percentage of infants with abnormal image findings. Results showed that 48% of the group had a normal MRI. At 36 weeks PCA 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. This data suggests that functional manifestations of MRI findings may not be declared until later stages of development. These initial findings have been submitted as an abstract entitled """"""""Comparison Between Neuroimaging and Neurobehavioral Assessments of the Very Low Birthweight Preterm Infant"""""""" to the American Pediatric Society/The Society for Pediatric Research for the May 1999 meeting in San Francisco.
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