Volume 24, Issue 104, July - August, 2020

Cranial ultrasonography can predict the neurodevelopmental outcomes in preterm neonates?

Tran Kiem Hao¹, Ton Nu Van Anh^2♦, Nguyen Thi Diem Chi¹, Nguyen Huu Son¹, Nguyen Thi Hong Duc¹, Tran Vinh Phu²

¹Pediatric Center, Hue Central Hospital, Hue city, Vietnam
²Pediatric Department, Hue University of Medicine and Pharmacy, Hue University, Vietnam

^♦Corresponding author
Asso. Professor in Pediatrics, Hue University of Medicine and Pharmacy, Hue University, Vietnam; Email: tonnuvananh@huemed-univ.edu.vn

ABSTRACT

Background: Preterm birth is correlated with cerebral lesions such as hypoxia-ischaemia and haemorrhage. It is important to fully provide their parents with the potential prognostic information for the neonates, and most do this with the role of some neuroimaging modalities. This study aims to evaluate if it is possible to predict the short-term neurodevelopmental outcomes in preterm infants who develop hemorrhagic, ischemic or other brain lesions that are recognized on routine cranial ultrasound examinations? Methods. We prospectively evaluated the correlation of cerebral lesions found by cranial ultrasound and the developmental delays at the age of 6 months in 79 preterm infants (born before the 37th postmenstrual week). Cerebral ultrasound findings were reported as four categories: 1) Intraventricular haemorrhage; 2) Periventricular leukomalacia; 3) Ventricular dilatation; 4) Other lesions such as congenital anomaly, cystic lesion. Developmental evaluation at the age of 6 months was performed by Denver II screening test and during a neurologic examination. Results: Of 79 preterm infants, 24.1% had delayed mental or psychomotor development or both. Abnormal ultrasound findings, which were significantly correlated with the developmental delays, consisted of intraventricular haemorrhage (RR=9.6), periventricular leukomalacia (RR=10.3), ventricular dilatation (RR=18), congenital anomaly (RR=18) and cystic lesion (RR=18). Some perinatal factors such as Apgar score < 7at 5 mins, the disease of hyaline membranes, and mechanical ventilation were each correlated to increased risk of developmental delays. Conclusion: Cranial ultrasound is an excellent non-invasive modality for the screening of brain lesions in preterm newborns during hospitalization. Therefore, physicians could predict short-term neurodevelopmental outcomes.

Keywords: Cranial ultrasound, premature newborn, neurodevelopmental

Medical Science, 2020, 24(104), 2045-2051

PDF