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DOI: 10.1055/a-2057-7454
Relationship between Ventricular Size on Latest Ultrasonogram and the Bayley Scores ≥ 18 Months in Extremely Low Gestational Age Neonates: A Retrospective Cohort Study
Funding This work was supported by George L. MacGregor Professorship (C.R.R.) from the University of Texas Southwestern Medical Center and by Children's Medical Center Clinical Advisory Committee (CCRAC)—Senior Investigator Research Award—New Direction (L.P.B.). The study sponsors had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review and approval of the manuscript, and decision to submit the manuscript for publication.
Abstract
Objective A ventricle-to-brain index (VBI) >0.35 is associated with low scores on the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) in preterm infants with birth weight <1,250 g. However, VBI obtained at the third ventricle has only moderate interobserver reliability. The objective of this study was to test (1) reliability of VBI measured at the foramen of Monro on the latest ultrasonogram (US) before discharge using the intraclass correlation coefficient (ICC) and (2) the relationship between VBI and BSID-III scores at ≥18 months corrected age.
Study Design The present study is a single-center retrospective cohort study.
Results The study included 270 preterm infants born at 230/7 to 286/7 weeks of gestational age. The ICC of VBI between independent measurements by two study radiologists on the first 50 patients was 0.934. Factors associated with the value of VBI included severe intraventricular hemorrhage, bronchopulmonary dysplasia, and systemic steroid administration for BPD but not postmenstrual age. In multivariate analysis, VBI was negatively and independently associated with cognitive (p = 0.002), language (p = 0.004), and motor (p < 0.001) BSID-III scores. The association between VBI and BSID-III scores was observed even in infants in whom the latest US was obtained before term equivalent age. The association between VBI and BSID-III scores was also observed after excluding those with severe intraventricular hemorrhage.
Conclusion In this very preterm cohort the measurement of VBI had excellent reliability. Moreover, VBI measurements were negatively associated with motor, language, and cognitive BSID-III scores.
Key Points
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Mean values of VBI are stable with postmenstrual age.
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Values at the foramen of Monro are reliable and reproducible.
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VBI is negatively associated with Bayley scores.
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The association is observed even before term age.
Note
This study was presented as poster at the Pediatric Academy Societies Meeting, Denver, CO, April 23, 2022.
Authors' Contributions
J.D.R., R.H., T.H., RC., C.R.R., and L.P.B. conceptualized and designed the study. K.T.-P. conducted the Bayley score assessments. M.C. was the research coordinator for the QI project. P.J.B. collected and entered data into the NICU database. S.B. conducted statistical analyses. All authors participated in the interpretation of the data, critically reviewed the revisions, approved the final manuscript as submitted, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Publication History
Received: 09 November 2022
Accepted: 14 March 2023
Accepted Manuscript online:
18 March 2023
Article published online:
24 April 2023
© 2023. Thieme. All rights reserved.
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