Browsing by Author "Taylor, H. Gerry"

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    Early school outcomes for extremely preterm infants with transient neurological abnormalities
    (Wiley, 2015-09) Harmon, Heidi; Taylor, H. Gerry; Minich, Nori; Wilson-Costello, Deanne; Hack, Maureen; Department of Medicine, IU School of Medicine
    AIM: To determine if transient neurological abnormalities (TNA) at 9 months corrected age predict cognitive, behavioral, and motor outcomes at 6 years of age in extremely preterm infants. METHOD: A cohort of 124 extremely preterm infants (mean gestational age 25.5wks; 55 males, 69 females), admitted to our unit between 2001 and 2003, were classified based on the Amiel-Tison Neurological Assessment at 9 months and 20 months corrected age as having TNA (n=17), normal neurological assessment (n=89), or neurologically abnormal assessment (n=18). The children were assessed at a mean age of 5 years 11 months (SD 4mo) on cognition, academic achievement, motor ability, and behavior. RESULTS: Compared with children with a normal neurological assessment, children with TNA had higher postnatal exposure to steroids (35% vs 9%) and lower adjusted mean scores on spatial relations (84 [standard error {SE} 5] vs 98 [SE 2]), visual matching (79 [SE 5] vs 91 [SE 2]), letter-word identification (97 [SE 4] vs 108 [SE 1]), and spelling (76 [SE 4] vs 96 [SE 2]) (all p<0.05). INTERPRETATION: Despite a normalized neurological assessment, extremely preterm children with a history TNA are at higher risk for lower cognitive and academic skills than those with normal neurological findings during their first year of school.
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    Preterm Neuroimaging and School-Age Cognitive Outcomes
    (American Academy of Pediatrics, 2018-07) Hintz, Susan R.; Vohr, Betty R.; Bann, Carla M.; Taylor, H. Gerry; Das, Abhik; Gustafson, Kathryn E.; Yolton, Kimberly; Watson, Victoria E.; Lowe, Jean; DeAnda, Maria Elena; Ball, M. Bethany; Finer, Neil N.; Van Meurs, Krisa P.; Shankaran, Seetha; Pappas, Athina; Barnes, Patrick D.; Bulas, Dorothy; Newman, Jamie E.; Wilson-Costello, Deanne E.; Heyne, Roy J.; Harmon, Heidi M.; Peralta-Carcelen, Myriam; Adams-Chapman, Ira; Duncan, Andrea Freeman; Fuller, Janell; Vaucher, Yvonne E.; Colaizy, Tarah T.; Winter, Sarah; McGowan, Elisabeth C.; Goldstein, Ricki F.; Higgins, Rosemary D.; Pediatrics, School of Medicine
    BACKGROUND AND OBJECTIVES: Children born extremely preterm are at risk for cognitive difficulties and disability. The relative prognostic value of neonatal brain MRI and cranial ultrasound (CUS) for school-age outcomes remains unclear. Our objectives were to relate near-term conventional brain MRI and early and late CUS to cognitive impairment and disability at 6 to 7 years among children born extremely preterm and assess prognostic value. METHODS: A prospective study of adverse early and late CUS and near-term conventional MRI findings to predict outcomes at 6 to 7 years including a full-scale IQ (FSIQ) <70 and disability (FSIQ <70, moderate-to-severe cerebral palsy, or severe vision or hearing impairment) in a subgroup of Surfactant Positive Airway Pressure and Pulse Oximetry Randomized Trial enrollees. Stepwise logistic regression evaluated associations of neuroimaging with outcomes, adjusting for perinatal-neonatal factors. RESULTS: A total of 386 children had follow-up. In unadjusted analyses, severity of white matter abnormality and cerebellar lesions on MRI and adverse CUS findings were associated with outcomes. In full regression models, both adverse late CUS findings (odds ratio [OR] 27.9; 95% confidence interval [CI] 6.0-129) and significant cerebellar lesions on MRI (OR 2.71; 95% CI 1.1-6.7) remained associated with disability, but only adverse late CUS findings (OR 20.1; 95% CI 3.6-111) were associated with FSIQ <70. Predictive accuracy of stepwise models was not substantially improved with the addition of neuroimaging. CONCLUSIONS: Severe but rare adverse late CUS findings were most strongly associated with cognitive impairment and disability at school age, and significant cerebellar lesions on MRI were associated with disability. Near-term conventional MRI did not substantively enhance prediction of severe early school-age outcomes.