Department of Pediatrics, State University of New York, Downstate Medical Center, Brooklyn, New York, USA.
BMJ Open. 2013 Apr 24;3(4). doi: 10.1136/bmjopen-2012-002499. Print 2013.
To assess the clinical usefulness of measurement of corpus callosum (CC) size in head ultrasound (HUS) to predict short-term neurodevelopmental (ND) outcomes in preterm infants. We hypothesised that including CC measurements in routine HUS will be an additional tool for early identification of infants at risk of adverse short-term ND outcome, over and above the predictive power of perinatal morbidities.
Retrospective cohort study.
Level III neonatal intensive care unit (NICU) and outpatient NICU follow-up clinic of an academic medical centre in New York City.
929 HUS of 502 infants with gestational age of 23-36 weeks in African-American infants were initially studied. Exclusion criteria included those who died, had gross abnormalities in HUS, infants with race other than African-American, infants with suboptimal quality of HUS, late preterm infants and infants who did not participate in ND follow-up. A total of 173 infants completed the study.
CC size (length and thickness) was measured in a subset of 87 infants who had routine HUS between 23 and 29 weeks (0-6 postnatal weeks). Relevant clinical variables were collected from chart reviews. ND assessments were completed in outpatient follow-up clinics. A statistical model was developed to assess the clinical utility and possible predictive value of CC measurements for adverse short-term ND outcome, while adjusting for perinatal morbidities.
CC size and ND status.
Measurements of CC size did not add substantial predictive power to predict short-term ND outcome beyond the information provided by the presence of morbidities related to prematurity.
No association was found between morbidities related to prematurity and short-term ND outcome and CC size in preterm infants. CC measurements in HUS early in life did not have an additional value in predicting short-term ND outcome, therefore did not seem to provide further clinical utility.
评估头颅超声（HUS）中胼胝体（CC）大小测量对预测早产儿短期神经发育（ND）结局的临床实用性。我们假设，在常规 HUS 中加入 CC 测量值将是一种额外的工具，可以在预测与早产相关的围产期疾病之外，早期识别有发生不良短期 ND 结局风险的婴儿。
回顾性队列研究。
纽约市一家学术医学中心的三级新生儿重症监护病房（NICU）和门诊 NICU 随访诊所。
最初研究了 502 名胎龄为 23-36 周的婴儿的 929 次 HUS，排除标准包括死亡的婴儿、HUS 存在明显异常的婴儿、非裔美国婴儿以外的种族的婴儿、HUS 质量不佳的婴儿、晚期早产儿和未参加 ND 随访的婴儿。共有 173 名婴儿完成了研究。
在 87 名 23-29 周（0-6 周新生儿期）期间进行常规 HUS 的婴儿亚组中测量 CC 大小（长度和厚度）。从图表回顾中收集相关临床变量。在门诊随访诊所完成 ND 评估。开发了一个统计模型，以评估 CC 测量值对不良短期 ND 结局的临床实用性和可能的预测价值，同时调整与早产相关的围产期疾病。
CC 大小和 ND 状态。
CC 大小的测量值除了提供与早产相关的疾病信息外，对预测短期 ND 结局没有提供实质性的预测能力。
在早产儿中，与早产相关的疾病与短期 ND 结局和 CC 大小之间没有发现相关性。HUS 早期的 CC 测量值在预测短期 ND 结局方面没有额外的价值，因此似乎没有提供进一步的临床实用性。
