In the first few weeks of life, babies born before 30 weeks of gestation may struggle just to survive. Later in childhood, former preemies are at increased risk of cerebral palsy (CP) as well as behavior, cognitive, and social difficulties. The good news is that early detection of disabilities and delays may help preemies get the treatment and educational support they need to thrive, and according to new research, magnetic resonance imaging (MRI) tests offer the best assessment of risk for developmental problems in preemies.
Researchers from New Zealand, Australia, and Washington University in St. Louis, Missouri, studied 167 very premature infants born at or before 30 weeks gestation. When the babies reached "term equivalent" (when they would have been considered full-term if they had remained in their mothers' wombs), they underwent MRI tests to check for injuries to the white matter and gray matter areas of the brain. The babies also had cranial ultrasonography, the most widely used method to examine the brain for abnormalities in premature infants. Two years later, the children underwent extensive developmental tests to assess their memory, learning, language, and communication abilities, motor skills, and vision and hearing.
By the second birthday, 17% of infants had severe cognitive delay, 10% had severe motor problems, 10% had cerebral palsy, and 11% had sensory impairment.
The researchers discovered that early brain abnormalities, especially injuries to the white matter, strongly predicted developmental problems by the second birthday. Moderate to severe white-matter abnormalities were associated with problems including cerebral palsy, severe cognitive delay, and severe psychomotor delay, as well as hearing and vision impairment. Gray-matter abnormalities were associated with cognitive delay, motor delay, and cerebral palsy.
The study authors suggest that MRIs are superior to cranial ultrasonography in assessing the risk for these types of neurodevelopmental problems in very premature infants.
What This Means to You. MRIs can be costly and infants can be difficult to scan, but the results of this study indicate that in babies at high risk for developmental problems, MRIs predict cognitive delays and disabilities more accurately than other diagnostic tests. If your baby is born prematurely and you have questions about your child's development, talk to your doctor or developmental specialist.
Source: Lianne J. Woodward, PhD; Peter J. Anderson, PhD; Nicola C. Austin, MD; Kelly Howard, BSc; Terrie E. Inder, MD; New England Journal of Medicine, August 17, 2006.
Reviewed by: Steven Dowshen, MD
Date reviewed: October 2006
