Preterm children with suspected cerebral palsy at 19 months corrected age in the Canadian neonatal follow-up network. (September 2019)

• Record Type: Journal Article
• Authors: Synnes, Anne; Gillone, Jenna; Majnemer, Annette; Lodha, Abhay; Creighton, Dianne; Moddemann, Diane; Shah, Prakesh S.
• Is Part Of: Early human development. Volume 136(2019)
• Page Start: 7
• Page End: 13
• Publication Date: 2019-09
• Subjects: ASQ-3 Ages and Stages Questionnaire third edition -- Bayley-III Bayley Scales of Infant and Toddler Development-Third Edition -- BPD bronchopulmonary dysplasia -- CA corrected age -- CNFUN Canadian Neonatal Follow-Up Network -- CNN Canadian Neonatal Network™ -- CP cerebral palsy -- GA gestational age -- GMFCS Gross Motor Function Classification System -- HSCS-PS Health Status Classification System- Preschool version, NICU- neonatal intensive care unit -- NDI neurodevelopmental impairment -- SNAP-II Score for Neonatal Acute Physiology second version -- sNDI significant neurodevelopmental impairment; Cerebral palsy -- Prematurity -- Motor impairments; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2019.06.009
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Background: The ability to definitively diagnose cerebral palsy (CP) at 18–24 months is unknown. Aims: To describe very preterm children who, at 19 months, have suspected CP defined as neither having a definitive diagnosis of CP nor no CP and compare them with children with and without CP. Study design and methods: Longitudinal national cohort study of births <29 weeks' gestation with linked Canadian Neonatal Network and Canadian Neonatal Follow-up Network data with 19 month assessments and 3-year questionnaires (Ages and Stages-3 and Health Status Classification System-Preschool). CP, no CP and suspected CP groups, classified at 19 months, were compared using chi square and ANOVA. Results: Of 3086 survivors, 2280 had complete 19-month corrected age (CA) and 1261 had 3-year CA data. Suspected CP (3.6%), CP (6.4%) and no CP (90%) groups differed ( p < 0.05) in birth weight, gestational age, complications of prematurity and NICU length of stay. Children with suspected CP had Bayley-III motor, cognitive and language composite scores at 18 months midway between CP and no CP, had the lowest sensory impairment rates and highest hospital readmission rates. At 3 years, gross motor, fine motor, problem-solving, communication and social skill abilities differed: abnormal outcomes were intermediate for children with suspected CP ( p < 0.01). Conclusions: CP incidence varied from 6.4% to 10% with exclusion or inclusion of children with suspected CP. Children with suspected CP have characteristics mostly midway between those with and without CP and developmental concerns persist to 3 years and require surveillance beyond 19 months. Highlights: Definitive cerebral palsy occurs in 6.4% of preterms at 18 months. Suspected cerebral palsy occurs in 3.6% of preterms at 18 months. Children with suspected cerebral palsy differ from those without. With suspected cerebral palsy, developmental concerns persist to 3 years of age.