Comparative assessment of the new method for neurological examination of pre-term babies

BACKGROUND: Diseases of the nervous system and mental disorders have a leading place in the structure of childhood disability. Perinatal factors are principal in the development of nervous system damage in children. Of particular importance in the formation of perinatal disorders of the nervous system are lesions of the brain of pre-term infants, which is due to the specific morphology, functional and neurochemical characteristics of the brain of a pre-term baby. The listed circumstances determine the need to create a diagnostic system that allows the earliest possible identification of deviant signs in the structure and function of the nervous system in pre-term infants of different gestational age. Previously, the low diagnostic and prognostic value of a routine neurological examination was shown. A scheme for assessing the neurological state of a pre-term baby depending on the gestational age is proposed. The scheme is based on the principles of developmental neurology: continuity of neurological functions in the embryo, fetus, newborn and infant; optimality; standardization; quantification; a system of “credits” for the quantitative assessment of neurological states. AIM: The purpose of this study was clinical testing of the early developed scheme. MATERIALS AND METHODS: Using a routine neurological examination, a proposed original scheme for quantitative and qualitative assessment of the neurological status of the pre-term infant, and cranial ultrasonography, 40 pre-term infants during the neonatal period were examined. A follow-up study was carried out at 18 corrected months through a routine neurological examination, cranial ultrasonography, and the Denver Screening Test using the Development Quotient calculation. RESULTS: It has been shown that a routine neurological examination has low specificity (6.6%) and negative predictive value (14.3%), which indicates its low ability to identify normal conditions of the nervous system in the acute period and predict optimal development. Cranial ultrasonography has low sensitivity (33.3%). The tested scheme showed high sensitivity (100%), specificity (100%), positive (83.3%) and negative (100%) predictive values. CONCLUSIONS: Clinical testing of the new scheme for assessing the neurological status of a pre-term baby showed its high diagnostic and prognostic value.