In neonatal and young infants of premature birth, intracranial hemorrhage (ICH), periventricular echodensity (PE), periventricular cysts (PC), ventricular size (VS), and brain/cranial growth will be studied by a combination of cranial ultrasound (US) techniques. Portable real-time sector-scans which do not interfere with intensive care management of the infant subjects will be used during the nursery course of preterm infants to detect ICH, PE, and PC's, and to measure VS and brain growth. Following discharge, the neurodevelopment of all subjects will be assessed at intervals until age 60 months using the Bayley Scales of Infant Development, Peabody Picture Vocabulary Test, Wechsler Preschool and Primary Scale Intelligence Test, other selected psychological tests and standard neurological evaluations. The US studies will be examined independently by two radiologists who will not know the risk category, the results of previous examinations, or the outcome of the infants. The profile of the mother and primary caretaker pertaining to social, familial and environmental factors (SES/demographic index) will be determined. The objectives of the proposed research, a continuation and extension of our ongoing studies in small preterm infants, are to determine 1) the relationships of ICH, PE, PC's and VS and head circumference to neurodevelopment and 2) the relationships of perinatal factors and complications to the results of the US and developmental examinations. The hypotheses to be tested therefore, are as follows: A. Are neurosonographic abnormalities (ICH, PE, PC's) during the early nursery course of preterm infants correlated with subsequent ventricular and cranial growth measurements and with specific aspects of neurodevelopment, independent of SES/Demographic indices? B. Are neurosonographic abnormalities (ICH, PE, PC's) and ventricular and cranial growth measurements related to perinatal factors/complications, independent of SES/Demographic index? The purpose of the research is to define in preterm infants the adverse effects of neurosonographic abnormalities on subsequent ventricular and cranial growth, and to determine the clinical value of US and cranial measures in predicting early neurodevelopment.
