Cranial Ultrasound and Minor Motor Abnormalities at 2 Years in Extremely Low Gestational Age Infants.
Sara B DeMauro, Carla Bann, John Flibotte and 2 others
PMID 31880687WHAT IT FOUND
Minor motor issues like stiff posture or poor hand control were more common in infants with severe ultrasound findings, but not low-grade ones.
Children with any minor motor abnormality used more therapy and feeding supports than peers with normal exams.
Key findings
01Adjusted odds of minor axial tone abnormalities, upper extremity function abnormalities, and GMFCS level 1 were significantly higher in children with more severe CUS findings.
02The overall prevalence of minor motor abnormality in the absence of major motor abnormality did not increase substantially with CUS findings.
03Adjusted odds of requiring home equipment, occupational or physical therapy, or anticonvulsant/anti-spasticity medications were higher in children with minor motor abnormalities, compared to those with normal exams.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only 73% of the eligible sample had complete data, and included children differed slightly from excluded ones in rates of antenatal steroids, PDA, and sepsis. Motor assessments were based on a single exam at 18-26 months, which may miss evolving deficits. The study used clinical-grade cranial ultrasounds, which have lower sensitivity for low-grade abnormalities compared to research-grade imaging. Children with 'possible level 1' GMFCS were classified as normal, which may have underestimated the prevalence of minor motor issues.
Declared interests
The authors have no conflicts of interest to disclose. The study was supported by the NIH.
The easy way to misread this
Do not assume that a normal or low-grade cranial ultrasound rules out minor motor impairment. Forty-nine percent of children with normal imaging had minor motor abnormalities, and low-grade IVH was not associated with increased minor motor risk. Clinical examination remains essential.