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Cerebral Palsy and Motor Impairment After Extreme Prematurity: Prediction of Diagnoses at Ages 2 and 10 Years

2024; Elsevier BV; Volume: 271; Linguagem: Inglês

10.1016/j.jpeds.2024.114037

1097-6833

Timothy Marinelli, Joe Yi, T. Michael O’Shea, Robert M. Joseph, Stephen R. Hooper, Karl Kuban, Christina Sakai, Michael E. Msall, Rebecca C. Fry, Rachana Singh, Julie V. Rollins, Bhavesh Shah, Linda Van Marter, Camilla Martin, Janice Ware, Caitlin K. Rollins, Cynthia Cole, James M. Perrin, Christina Sakai, Frank Bednarek, Richard A. Ehrenkranz, Jennifer Benjamin, Angela Montgomery, T. Michael O’Shea, Lisa K. Washburn, Carl Bose, Diane Warner, Steve Engelke, Amanda Higginson, Jason Higginson, K. Bear, Mariel Poortenga, Steve Pastyrnak, Padu Karna, Nigel Paneth, Madeleine Lenski, Michael D. Schreiber, Scott J. Hunter, Deborah Klein, Maureen Pimental, Collen Hallisey, Taryn Coster, Maddie Dolins, Maggie Mittleman, Hannah Haile, Julia Rohde, Kaysi Herrera Pujols, Ellen Nylen, Emily Neger, Kathryn Mattern, Catherine Ma, Deanna Toner, Elizabeth Vitaro, Lauren Venuti, Beth Powers, Ann Foley, EdM, Taylor Merk, Joanne Williams, Elaine Romano, Christine Henry, Debbie Hiatt, Nancy Peters, Patricia Brown, Emily Ansusinha, Jazmyne James, Nou Yang, Gennie Bose, Janice Wereszczak, Janice Bernhardt, Joan Adams, Donna Wilson, Nancy Darden-Saad, Bree Williams, Emily Jones, Hannah Morris, Dinah Sutton, Julie Rathbun, Stephanie Fagerman, William Boshoven, Jalen Johnson, Brandon James, Cynthia Gile, Karen Miras, Carolyn Solomon, Deborah Weiland, Rugile Ramoskaite, Suzanne Wiggins, Krissy Washington, Ryan J. Martin, Barbara Prendergast, Emma Lynch, Sabina Hajdarovic, Beth Kring, Anne Smith, Susan McQuiston, Samantha Butler, Rachel Wilson, Kirsten McGhee, Patricia Lee, Aimee Asgarian, Anjali Sadhwani, Brandi Henson, Cecelia Keller, Jenifer Walkowiak, Susan Barron, Alice Miller, Brian Dessureau, Molly Wood, Jill Damon-Minow, Elaine Romano, Linda C. Mayes, Kathy Tsatsanis, Katarzyna Chawarska, Sophy Kim, Susan Dieterich, Karen Bearrs, Ellen Waldrep, Jackie Friedman, Gail Hounshell, Debbie Allred, Rebecca Helms, Lynn Whitley, Gary Stainback, Lisa Bostic, Amanda Jacobson, Joni McKeeman, Echo Meyer, Steve Pastyrnak, Joan T. Price, E. Lloyd, Susan Plesha‐Troyke, Megan Scott, Katherine M. Solomon, Kara Brooklier, Kelly Vogt,

Neonatal Respiratory Health Research

Objective To identify perinatal factors in children born extremely preterm (EP) that were associated with motor impairment (MI) at 2 and 10 years of age and develop a predictive algorithm to estimate the risk of MI during childhood. Methods Participants of the ELGAN Study were classified as: no MI, MI only at 2 years, MI only at 10 years, and MI at both 2 and 10 years, based on a standardized neurological examination at 2 and the Gross Motor Function Classification System at 10 years of age. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to develop the final predictive model. Results Of the 849 study participants, 64 (7.5%) had a diagnosis of MI at both 2 and 10 years and 63 (7.4%) had a diagnosis of MI at one visit but not the other. Of 22 total risk factors queried, 4 variables most reliably and accurately predicted MI: gestational age, weight z-score growth trajectory during NICU stay, ventriculomegaly, and cerebral echolucency on head ultrasound. By selecting probability thresholds of 3.5% and 7.0% at ages 2 and 10, respectively, likelihood of developing MI can be predicted with a sensitivity and specificity of 71.2%/72.1% at age 2 and 70.7%/70.7% at age 10. Conclusion In our cohort, the diagnosis of MI at 2 years did not always predict a diagnosis of MI at 10 years. Specific risk factors are predictive of MI and can estimate an individual infant's risk at NICU discharge of MI at age 10 years.