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Systematic Reviews
Published in: Systematic Reviews 1/2015

Open Access 01-12-2015 | Research

Predicting developmental outcomes in premature infants by term equivalent MRI: systematic review and meta-analysis

Authors: Janneke van’t Hooft, Johanna H. van der Lee, Brent C. Opmeer, Cornelieke S. H. Aarnoudse-Moens, Arnold G. E. Leenders, Ben Willem J. Mol, Timo R. de Haan

Published in: Systematic Reviews | Issue 1/2015

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Abstract

Background

This study aims to determine the prognostic accuracy of term MRI in very preterm born (≤32 weeks) or low-birth-weight (≤1500 g) infants for long-term (>18 months) developmental outcomes.

Methods

We performed a systematic review searching Central, Medline, Embase, and PsycInfo. Two independent reviewers performed study selection, data extraction, and quality assessment. We documented sensitivity and specificity for three different MRI findings (white matter abnormalities (WMA), brain abnormality (BA), and diffuse excessive high signal intensity (DEHSI)), related to developmental outcomes including cerebral palsy (CP), visual and/or hearing problems, motor, neurocognitive, and behavioral function. Using bivariate meta-analysis, we estimated pooled sensitivity and specificity and plotted summary receiver operating characteristic (sROC) curves for different cut-offs of MRI.

Results

We included 20 papers published between 2000 and 2013. Quality of included studies varied. Pooled sensitivity and specificity values (95 % confidence interval (CI)) for prediction of CP combining the three different MRI findings (using normal/mild vs. moderate/severe cut-off) were 77 % (53 to 91 %) and 79 % (51 to 93 %), respectively. For prediction of motor function, the values were 72 % (52 to 86 %) and 62 % (29 to 87 %), respectively. Prognostic accuracy for visual and/or hearing problems, neurocognitive, and/or behavioral function was poor. sROC curves of the individual MRI findings showed that presence of WMA provided the best prognostic accuracy whereas DEHSI did not show any potential prognostic accuracy.

Conclusions

This study shows that presence of moderate/severe WMA on MRI around term equivalent age can predict CP and motor function in very preterm or low-birth-weight infants with moderate sensitivity and specificity. Its ability to predict other long-term outcomes such as neurocognitive and behavioral impairments is limited. Also, other white matter related tests as BA and DEHSI demonstrated limited prognostic value.

Systematic review registration

PROSPERO CRD42013006362
Appendix
Available only for authorised users
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Metadata
Title
Predicting developmental outcomes in premature infants by term equivalent MRI: systematic review and meta-analysis
Authors
Janneke van’t Hooft
Johanna H. van der Lee
Brent C. Opmeer
Cornelieke S. H. Aarnoudse-Moens
Arnold G. E. Leenders
Ben Willem J. Mol
Timo R. de Haan
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2015
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-015-0058-7

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