Prognostic Indicators of Gross Motor Developmental Outcomes in Preterm Infants with Cerebral Insults as Detected by Neuroimaging

Kim, Seung Hyo; Kim, Se Hee; Kim, Hun Min; Lim, Byung Chan; Chae, Jong Hee; Kim, Ki Joong; Hwang, Yong Seung; Choi, Chang Won; Kim, Beyong Il; Hwang, Hee

Abstract

PURPOSE
To examine the developmental outcome of preterm infants with cerebral insults and to evaluate the prognostic indicators for gross motor development.
METHODS
Forty-eight preterm infants less than 37 weeks of gestation, who had been born at Seoul National University Bundang Hospital between March, 2004 and September, 2008 where the subjects of this. The infants' charts were reviewed to obtain data, including gestational age, birth weight, gender, 1/5 minute Apgar scores, neuroimaging findings, and others.
RESULTS
Of the 48 patients, 29 infants (60.4%) were put into a normal developmental group and 19 (39.6%) were put into developmental delay group. Univariate analysis of the two groups showed that P values less than 0.05 were observed with respect to gestational age, premature rupture of membrane (PROM), respiratory distress syndrome, bronchopulmonary dysplasia, and patent ductus arteriosus. PROM and antenatal steroid showed statistically significant differences on a multivariate analysis. The same analysis method was applied to preterm infants less than a corrected age of 32 weeks. Multivariate analysis suggested that PROM showed statistically significant differences. Also, 48 patients were analyzed with respect to neuroimage finding. Twenty-five infants (52.1%) were assigned to a germinal matrix hemorrhage (GMH) group and 23 infants (47.9%) were allocated to a non-GMH group. Cesarean section delivery showed statistically significant difference according to univariate analysis.
CONCLUSION
In preterm infants with cerebral insults, PROM and antenatal steroids were independent risk factors for impaired gross motor development.