The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants

Detalhes bibliográficos
Autor(a) principal: Mello, Rosane R.
Data de Publicação: 1998
Outros Autores: Dutra, Maria Virgínia P., Silva, Kátia S., Lopes, José Maria A.
Tipo de documento: Artigo
Idioma: por
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/24399
Resumo: OBJECTIVE: To verify the predictive value of two tests (neurological assessment and ultrasonography) performed at the time of discharge, with respect to the neuromotor and cognitive development of premature infants. METHODS: Seventy very low birth weight premature infants (below 1,500g), admitted to the Neonatal Department between 1992 and 1994 were studied. The average birth weight and gestation age were, respectively, 1,185g (SD:180g) and 32.2 weeks (SD: 1.4). At the term correct age, neurological assessment by the Dubowitz & Dubowitz method and cerebral ultrasonography were carried out. After discharge, the development was monitored at the follow up clinic. RESULTS: At 21 months correct age (SD: 4.9), neuromotor and cognitive abnormalities were observed, respectively, in 25.7% and 20.3% of the infants evaluated. The neonatal neurological assessment was found to be more sensitive than those specific for neuromotor (sensibility:77.7%, specificity:57.6%) and cognitive (sensibility:78.5%, specificity:56.4%) abnormalities, and exhibited low predictive value for both neuromotor and cognitive abnormality. Ultrasonography exhibited high specificity with respect to both neuromotor and cognitive development. The cerebral ultrasonography has also a reasonable predictive value for neuromotor abnormality. CONCLUSION: The combination of both tests yielded higher predictive values.
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spelling The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants Valores de predição da avaliação neurológica e ultra-sonográfica cerebral neonatal em relação ao desenvolvimento de prematuros de muito baixo peso Prematuro^i1^screscimePrematuro^i1^sdesenvolvimeMuito baixo peso ao nascerExame neurológicoSintomas cognitivosInfant^i2^sprematInfant^i2^svery low birth weiNeurologic examinationCognitive symptons OBJECTIVE: To verify the predictive value of two tests (neurological assessment and ultrasonography) performed at the time of discharge, with respect to the neuromotor and cognitive development of premature infants. METHODS: Seventy very low birth weight premature infants (below 1,500g), admitted to the Neonatal Department between 1992 and 1994 were studied. The average birth weight and gestation age were, respectively, 1,185g (SD:180g) and 32.2 weeks (SD: 1.4). At the term correct age, neurological assessment by the Dubowitz & Dubowitz method and cerebral ultrasonography were carried out. After discharge, the development was monitored at the follow up clinic. RESULTS: At 21 months correct age (SD: 4.9), neuromotor and cognitive abnormalities were observed, respectively, in 25.7% and 20.3% of the infants evaluated. The neonatal neurological assessment was found to be more sensitive than those specific for neuromotor (sensibility:77.7%, specificity:57.6%) and cognitive (sensibility:78.5%, specificity:56.4%) abnormalities, and exhibited low predictive value for both neuromotor and cognitive abnormality. Ultrasonography exhibited high specificity with respect to both neuromotor and cognitive development. The cerebral ultrasonography has also a reasonable predictive value for neuromotor abnormality. CONCLUSION: The combination of both tests yielded higher predictive values. OBJETIVO: Verificar os valores de predição de dois exames (neurológico e ultra-sonográfico) realizados no período neonatal, em relação ao desenvolvimento neuromotor e cognitivo de prematuros. MÉTODO: Foram estudados 70 prematuros com peso de nascimento inferior a 1.500g. A média do peso de nascimento e idade gestacional foram, respectivamente, 1.185g (DP:180) e 32,2 semanas (DP:1,4). Foi realizada avaliação neurológica pelo método de Dubowitz e Dubowitz e ultra-sonografia cerebral por volta de 40 semanas de idade corrigida. Após a alta do berçário estas crianças foram acompanhadas no ambulatório de seguimento. RESULTADOS: Com idade média de 21 meses (DP: 4,9) corrigidos para a prematuridade, 25,7% das crianças apresentaram comprometimento neuromotor, e 20,3%, alteração cognitiva. O exame neurológico neonatal foi mais sensível que específico em relação à alteração neuromotora (sensibilidade:77,7%, especificidade:57,6%), e cognitiva (sensibilidade: 78,5%, especificidade: 56,4%), e apresentou baixo valor de predição tanto para alteração neuromotora (38,9%) quanto cognitiva (31,4%). A ultra-sonografia apresentou elevada especificidade tanto para o desenvolvimento neuromotor (92,3%) quanto cognitivo (89,1%). O valor preditivo da ultra-sonografia foi satisfatório para anormalidades neuromotoras (69,2%), porém baixo para as alterações cognitivas (50,0%). CONCLUSÃO: A associação dos dois exames com resultados anormais apresentou valores de predição mais elevados para as anormalidades nas duas áreas do desenvolvimento. Universidade de São Paulo. Faculdade de Saúde Pública1998-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/2439910.1590/S0034-89101998000500004Revista de Saúde Pública; Vol. 32 No. 5 (1998); 420-429 Revista de Saúde Pública; Vol. 32 Núm. 5 (1998); 420-429 Revista de Saúde Pública; v. 32 n. 5 (1998); 420-429 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/rsp/article/view/24399/26323Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessMello, Rosane R.Dutra, Maria Virgínia P.Silva, Kátia S.Lopes, José Maria A.2012-05-29T16:59:43Zoai:revistas.usp.br:article/24399Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-05-29T16:59:43Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants
Valores de predição da avaliação neurológica e ultra-sonográfica cerebral neonatal em relação ao desenvolvimento de prematuros de muito baixo peso
title The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants
spellingShingle The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants
Mello, Rosane R.
Prematuro^i1^screscime
Prematuro^i1^sdesenvolvime
Muito baixo peso ao nascer
Exame neurológico
Sintomas cognitivos
Infant^i2^spremat
Infant^i2^svery low birth wei
Neurologic examination
Cognitive symptons
title_short The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants
title_full The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants
title_fullStr The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants
title_full_unstemmed The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants
title_sort The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants
author Mello, Rosane R.
author_facet Mello, Rosane R.
Dutra, Maria Virgínia P.
Silva, Kátia S.
Lopes, José Maria A.
author_role author
author2 Dutra, Maria Virgínia P.
Silva, Kátia S.
Lopes, José Maria A.
author2_role author
author
author
dc.contributor.author.fl_str_mv Mello, Rosane R.
Dutra, Maria Virgínia P.
Silva, Kátia S.
Lopes, José Maria A.
dc.subject.por.fl_str_mv Prematuro^i1^screscime
Prematuro^i1^sdesenvolvime
Muito baixo peso ao nascer
Exame neurológico
Sintomas cognitivos
Infant^i2^spremat
Infant^i2^svery low birth wei
Neurologic examination
Cognitive symptons
topic Prematuro^i1^screscime
Prematuro^i1^sdesenvolvime
Muito baixo peso ao nascer
Exame neurológico
Sintomas cognitivos
Infant^i2^spremat
Infant^i2^svery low birth wei
Neurologic examination
Cognitive symptons
description OBJECTIVE: To verify the predictive value of two tests (neurological assessment and ultrasonography) performed at the time of discharge, with respect to the neuromotor and cognitive development of premature infants. METHODS: Seventy very low birth weight premature infants (below 1,500g), admitted to the Neonatal Department between 1992 and 1994 were studied. The average birth weight and gestation age were, respectively, 1,185g (SD:180g) and 32.2 weeks (SD: 1.4). At the term correct age, neurological assessment by the Dubowitz & Dubowitz method and cerebral ultrasonography were carried out. After discharge, the development was monitored at the follow up clinic. RESULTS: At 21 months correct age (SD: 4.9), neuromotor and cognitive abnormalities were observed, respectively, in 25.7% and 20.3% of the infants evaluated. The neonatal neurological assessment was found to be more sensitive than those specific for neuromotor (sensibility:77.7%, specificity:57.6%) and cognitive (sensibility:78.5%, specificity:56.4%) abnormalities, and exhibited low predictive value for both neuromotor and cognitive abnormality. Ultrasonography exhibited high specificity with respect to both neuromotor and cognitive development. The cerebral ultrasonography has also a reasonable predictive value for neuromotor abnormality. CONCLUSION: The combination of both tests yielded higher predictive values.
publishDate 1998
dc.date.none.fl_str_mv 1998-10-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/24399
10.1590/S0034-89101998000500004
url https://www.revistas.usp.br/rsp/article/view/24399
identifier_str_mv 10.1590/S0034-89101998000500004
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/24399/26323
dc.rights.driver.fl_str_mv Copyright (c) 2017 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 32 No. 5 (1998); 420-429
Revista de Saúde Pública; Vol. 32 Núm. 5 (1998); 420-429
Revista de Saúde Pública; v. 32 n. 5 (1998); 420-429
1518-8787
0034-8910
reponame:Revista de Saúde Pública
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Revista de Saúde Pública
collection Revista de Saúde Pública
repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
repository.mail.fl_str_mv revsp@org.usp.br||revsp1@usp.br
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