Predictive value of neonatal neurological tests for developmental outcome of preterm infants

Background: There is a need to identify, as early as possible, infants who are at risk for long-term neurological morbidity. Methods: To predict neurodevelopment outcome of preterm infants <30 weeks' gestation in a population of 100 infants, we used several neonatal and neur obehavioral tests, including cranial ultrasonography, the Prechtl neurologi cal test, quality of spontaneous general movements, and quality of sleep-wa ke organization. Results: The Prechtl test at corrected term age and findings on cranial son ograms both had high specificity, but the Prechtl test had Letter overall p ositive predictive power for normal neurological and developmental outcomes at 2 years' corrected age. Developmental changes in sleep and the amount o f indeterminate sleep did not correlate with outcome. Scoring general movem ent quality did not predict outcome and did not augment the positive predic tive power of the Prechtl test. Conclusions: The Prechtl test at corrected term age (independent of the oth er tests) is the Lest positive predictor of normal neurological outcome and Bayley test results at 2 years' corrected age.