A longitudinal study of facial asymmetry in a normal birth cohort up to 6 years of age and the predisposing factors.

OBJECTIVES: This prospective, population-based cohort study aimed to investigate the development of facial asymmetry up to 6 years of age using a three-dimensional (3D) soft tissue imaging method in a normal population. In addition, the study sought to identify potential predisposing factors to facial asymmetry. METHODS: A total of 102 newborns were enrolled in the study at birth. 3D stereophotogrammetric images of the head and face were analysed at the ages of 12 months (T1), 3 years (T2), and 6 years (T3). The surface-based analysis involved the calculation of the average distance (mm) and the symmetry percentage (%) between the original and mirrored surfaces. For landmark-based analysis, the distance of facial landmarks to the facial midline was examined. RESULTS: The final analysis included 70 (68.6%) subjects. Surface-based analysis showed a significant improvement of facial symmetry from T1 to T3 in all facial areas. Landmark-based analysis showed that upper facial landmarks were located, on average, slightly on the left and lower facial landmarks slightly on the right in relation to the facial midline (P < 0.001). LIMITATIONS: The size of the study population was limited. Facial posture may affect the reliability of the results, especially in younger children. CONCLUSION: Facial asymmetry is detectable in early childhood and tends to reduce with age in young children. The lower face deviates slightly to the right, and the upper face to the left in relation to the facial midline. Possible predisposing factors for facial asymmetry at the age of 6 years include deformational plagiocephaly, sleeping position, and previous facial asymmetry.

Bilateral Motor Responses to Transcranial Magnetic Stimulation in Preterm Children at 9 Years of Age.

OBJECTIVE: This study was aimed to evaluate motor tracts integrity in nondisabled preterm-born (PT) children at 9 years of age. METHODS: Overall, 18 PT and 13 term-born (T) children without motor disability were assessed by transcranial magnetic stimulation (TMS). Motor-evoked potentials (MEPs) were measured bilaterally from the abductor pollicis brevis (APB) and the tibialis anterior (TA) muscles. Muscle responses could be stimulated from all patients. RESULTS: Overall, 83.3 and 23.1% of PT and T children, respectively, had mild clumsiness (p = 0.001). One PT and three T children had immediate bilateral responses in the upper extremities. Seven PT children had delayed ipsilateral APB responses after left and ten after right TMS. Three controls had delayed ipsilateral responses. Ipsilateral lower extremity responses were seen in one PT after right and two PT children and one T child after left TMS. The results did not correlate to groups, genders, clumsiness, or handedness. CONCLUSION: Children of PT and T may have bilateral motor responses after TMS at 9 years of age. Ipsilateral conduction emerges immediately or more often slightly delayed and more frequently in upper than in lower extremities. SIGNIFICANCE: Bilateral motor conduction reflects developmental and neurophysiological variability in children at 9 years of age. MEPs can be used as a measure of corticospinal tract integrity in PT children.

Neonatal outcomes among offspring of obese women diagnosed with gestational diabetes mellitus in early versus late pregnancy.

BACKGROUND: Maternal metabolic derangements associated with early pregnancy gestational diabetes may affect the fetus differently compared with gestational diabetes diagnosed later in pregnancy. The aim of this observational study was to assess neonatal outcomes according to timing of gestational diabetes diagnosis in obese women. METHODS: Women ≥18 years of age with a pre-pregnancy body mass index ≥30 kg/m2 were grouped according to the results of a 75 g 2-h oral glucose tolerance test performed at 13.1 weeks of gestation and repeated at 23.4 weeks if normal at first testing. The main outcomes were birthweight and large for gestational age. RESULTS: Out of 361 women, 164 (45.4%) were diagnosed with gestational diabetes, 133 (81.1%) of them in early pregnancy. The mean offspring birthweight was 3673 g (standard deviation (SD) 589 g) in the early and 3710 g (SD 552 g) in the late gestational diabetes group. In a multivariate logit model, the odds ratio for large for gestational age was 2.01 (95% CI: 0.39-10.39) in early compared with late gestational diabetes. CONCLUSIONS: We observed no statistically significant differences in neonatal outcomes according to timing of gestational diabetes diagnosis. In addition to lack of power, early treatment of hyperglycemia may partly explain the results.

Optimization of lentiviral vector production for scale-up in fixed-bed bioreactor.

Lentiviral vectors (LVs) are promising tools for gene therapy. However, scaling up the production methods of LVs in order to produce high-quality vectors for clinical purposes has proven to be difficult. In this article, we present a scalable and efficient method to produce LVs with transient transfection of adherent 293T cells in a fixed-bed bioreactor. The disposable iCELLis bioreactors are scalable with a large three-dimensional (3D) growth area range between 0.53 and 500 m2, an integrated perfusion system, and a controllable environment for production. In this study, iCELLis Nano (2.67-4 m2) was used for optimizing production parameters for scale-up. Transfections were first done using traditional calcium phosphate method, but in later runs polyethylenimine was found to be more reliable and easier to use. For scalable LV production, perfusion rate control by measuring cell metabolite concentrations in the bioreactor leads to higher productivity and reduced costs. Optimization of cell seeding density for targeted cell concentration during transfection, use of low compaction fixed-bed and lowering the culture pH have a positive effect on LV productivity. These results show for the first time that iCELLis bioreactor is scalable from bench level to clinical scale LV production.

3D follow-up study of facial asymmetry after developmental dysplasia of the hip.

OBJECTIVES: To evaluate the change in facial asymmetry among subjects treated for developmental dysplasia of the hip (DDH) from childhood to adolescence. SETTING AND SAMPLE POPULATION: A total of 39 adolescents (26 females and 13 males), born and treated for DDH during 1997-2001, participated in the first examination in 2007 (T1; at the age of 8.2) and in the follow-up in 2016 (T2; at the age of 16.6). MATERIAL AND METHODS: In this longitudinal study, three-dimensional (3D) images were taken using a 3DMD face system based on a stereophotogrammetric method. Facial asymmetry was determined as the average distance (mm) calculated between the original and superimposed mirrored face and the symmetry percentage (%) calculated as the face area where the distance between the original face and the mirrored surface does not exceed 0.5 mm. RESULTS: Results showed increased asymmetry from T1 to T2. The average distance increased for whole face (from 0.51 mm to 0.59 mm, P = .001), upper face (from 0.41 mm to 0.49 mm, P = .005), mid-face (from 0.48 mm to 0.57, P = .002) and lower face (from 0.74 mm to 0.85 mm, P = .147). Facial symmetry percentage decreased for whole face from 61.23% to 55.38% (P = .011), for upper face from 69.27% to 62.24% (P = .005) and for mid-face from 62.29% to 55.63% (P = .007) and for lower face from 43.37% to 42.19% (P = .66). CONCLUSION: Facial asymmetry increases from childhood to adulthood in subjects treated for DDH. Orthodontic treatment does not eliminate this asymmetric facial growth.

The effect of pre-pregnancy lifestyle counselling on food intakes and association between food intakes and gestational diabetes in high-risk women: results from a randomised controlled trial.

BACKGROUND: Healthy diets before and during pregnancy have been suggested to reduce the risk of gestational diabetes (GDM). Several lifestyle intervention studies for pregnant women have reported dietary improvements after counselling. However, evidence concerning the effect of counselling initiated before pregnancy on diets is limited. METHODS: This randomised controlled study explored whether pre-pregnancy lifestyle counselling influenced food intakes, as well as whether changes in food intakes were associated with GDM. The participants comprised 75 women with prior GDM and/or a body mass index ≥ 30 kg m-2 . Women were randomised into a control or an intervention group, and their food intakes were followed from pre-pregnancy to early pregnancy using a food frequency questionnaire. The control and intervention groups were combined to assess the association between changes in food intakes and GDM. The diagnosis of GDM was based on a 75-g oral glucose tolerance test conducted in the first and second trimester of pregnancy. RESULTS: Pre-pregnancy lifestyle counselling showed no major overall effect on food intakes. The intake of low-fat cheese increased significantly in women who did not develop GDM compared to women who did after adjusting for potential confounders (P = 0.028). This association was not observed for regular-fat cheese. CONCLUSIONS: The findings obtained in the present study suggest that an increased intake of low-fat but not regular-fat cheese between pre-pregnancy and early pregnancy is associated with a lower risk of GDM in high-risk women.

The course of positional cranial deformation from 3 to 12 months of age and associated risk factors: a follow-up with 3D imaging.

Deformational plagiocephaly is reported in up to 46.6 % of healthy infants, with the highest point prevalence at around 3 months of age. Few prospective studies on the natural course of skull deformation have been conducted, and we know of no studies using 3D imaging starting from the highest point prevalence period. In this prospective, population-based cohort study, we describe the course of cranial asymmetry and shape in an unselected population using 3D stereophotogrammetry and investigate factors associated with late cranial deformation and failure to recover from previous deformation. We evaluated 99 infants at 3, 6, and 12 months of age. We acquired 3D craniofacial images and performed structured clinical examinations and parental interviews at each visit. Eight outcome variables, representing different aspects of cranial shape, were calculated from a total of 288 3D images. Scores of asymmetry-related variables improved throughout the observation period. However, the rate of correction for cranial asymmetry decreased as the infants grew older, also in relation to the rate of head growth, and a significant amount of asymmetry was still present at 12 months. Positional preference at 3 months predicted an unfavorable course of cranial asymmetry after 3 months, increasing the risk for DP persisting. What is known: • The prevalence of deformational plagiocephaly spontaneously decreases after the first months of life. • Limited neck range of motion and infant positional preference increase the risk of deformational plagiocephaly during the first months of life. What is new: • Positional preference at 3 months predicts an unfavorable spontaneous course of deformation also from three to 12 months of age, presenting a potential target for screening and treatment. • The spontaneous rate of correction for cranial asymmetry decreases after 6 months of age, also in relation to the rate of head growth.

Preventing deformational plagiocephaly through parent guidance: a randomized, controlled trial.

Deformational plagiocephaly (DP) occurs frequently in otherwise healthy infants. Many infants with DP undergo physiotherapy or helmet therapy, and ample treatment-related research is available. However, the possibility of preventing DP has been left with little attention. We sought to evaluate the effectiveness of intervention in the newborn's environment, positioning, and handling on the prevalence of DP at 3 months and to investigate the causal relationship between DP and cervical imbalance. We carried out a randomized controlled trial, with healthy newborns randomized into two groups at birth. All families received standard positioning instructions to prevent SIDS. Additionally, the intervention group received detailed instructions regarding the infant's environment, positioning, and handling, with the goal of creating a nonrestrictive environment that promotes spontaneous physical movement and symmetrical motor development. Two- and three-dimensional photogrammetry served to assess cranial shape and goniometry to measure cervical motion. At 3 months, the prevalence of DP was lower in the intervention group in both 2D (11 vs 31 %) and 3D analyses (15 vs 33 %), and the asymmetry was milder in the intervention group. Infants with DP at follow-up had also developed more torticollis. CONCLUSION: An early educational intervention reduces the prevalence and severity of DP at 3 months. WHAT IS KNOWN: •Deformational plagiocephaly, often with associated torticollis, is common in healthy infants. •Parental education is frequently recommended for preventing deformational plagiocephaly, although information regarding the effectiveness of preventive strategies is scarce. WHAT IS NEW: •Early parent guidance effectively reduces the prevalence and severity of DP and improves the cervical range of motion at three months. •Educating both parents and professionals about proper infant positioning on a national scale could help minimize public healthcare costs.

Development and pilot of equine facilitated physical therapy outcome measure tool for chronic low back pain patients.

Equine Facilitated Physical Therapy (EFPT) lacks consistent documentation due to being an unconventional physical therapy treatment to chronic low back pain patients (LBP) and lacking rehabilitation outcome measure tools for a stable (equestrian) environment. The objectives were to develop an online evaluation tool as well as to define inter- and intra-rater reliability to validate the outcome measurement tool "Evaluation of maintaining sitting position (on a horse) and walking (short distances)" designed for LBP patients in EFPT". A total of 48 movement related functions (n = 48), were derived from the International Classification of Functioning (ICF) and organized to an online evaluation tool. Depending on the state of validation two to six (2-6) raters scored randomized patient (n = 22) video material, recorded during a 12-week EFPT intervention, with the designed tool. Inter-rater agreement level between the experts reached good (α = 87) reliability for the scoring of the items and calculated per patient excellent (α = 100). Intra-rater reliability reached good (α = 87) and per patient good (α = 80) repeatability. For the healthy adults the reliability between raters reached acceptable (α = 72) levels and per rated excellent (α = 100). The developed assessment tool was found satisfactory to fulfil the requirement for the therapeutic practice. With the use of the tool physical therapist may detect postural changes for LBP patients as outcome report in EFPT. The tool may be used to identify treatment progress and to help design home exercises. The created tool will help to collect similar outcome measures from LBP patients in EFPT and to validate the treatment within industry.

Plagiocephaly after Neonatal Developmental Dysplasia of the Hip at School Age.

Developmental dysplasia of the hip (DDH) may require early abduction treatment with infants sleeping on their back for the first few months of life. As sleeping on back is known to cause deformational plagiocephaly, we assessed school age children treated for dislocation or subluxation of the hip-joint in infancy. Plagiocephaly was analyzed by using cephalic index (CI) and oblique cranial length ratio (OCLR) as anthropometric measurements from 2D digital vertex view photographs. Six of the 58 (10.3%) DDH children and only one of the 62 (1.6%) control children had plagiocephaly (p = 0.041). Furthermore, cross bite was found in 14 (24.1%) of the DDH children and in 7 (10.3%) of the control children. Developmental dysplasia of the hip in infancy was associated with cranial asymmetries and malocclusions at school age. Preventive measures should be implemented.

Craniofacial Asymmetry from One to Three Years of Age: A Prospective Cohort Study with 3D Imaging.

Deformational plagiocephaly (DP) is considered a risk factor for facial asymmetry. This cohort-based, prospective, follow-up study used three-dimensional (3D) stereophotogrammetry to assess the development of facial asymmetry in a normal birth cohort and to investigate the impact of DP on facial asymmetry for the age range of one to three years. The study sample consisted of 75 children: 35 girls (47%) and 40 (53%) boys recruited from Oulu University Hospital. A total of 23 (31%) subjects had a history of DP in infancy. 3D facial images were obtained at the mean (SD) age of 1.01 (0.04) year old at T1 and 3.02 (0.14) years old at T2. To determine facial asymmetry, both landmark-based and surface-based facial symmetry methods were used. As measured with the surface-based methods, upper facial symmetry improved from T1 to T2 (p < 0.05). As measured with the landmark-based methods, facial symmetry improved on the upper and lower jaw from T1 to T2 (p < 0.05). The asymmetric effect of DP on the upper parts of the face tends to correct spontaneously during growth. Results indicate that previous DP does not seem to transfer to facial or occlusal asymmetry at the age of three years old.

A 3D Follow-Up Study of Cranial Asymmetry from Early Infancy to Toddler Age after Preterm versus Term Birth.

Preterm infants are at higher risk for both symmetrical and asymmetrical head molding. This study involved 3D stereophotogrammetry to assess the cranial growth, molding, and incidence of deformational plagiocephaly (DP) in preterm children compared to term born children. Thirty-four preterm infants and 34 term born controls were enrolled in this study from Oulu University Hospital, Finland. Three-dimensional head images were obtained at the age of 2-4 months (T1), 5-7 months (T2), 11-13 months (T3), and 2.5-3 years (T4) from the term equivalent age (TEA). There was no statistically significant difference in oblique cranial length ratio (OCLR), cephalic index (CI), or weighted asymmetry score (wAS) between the two groups. Occipital flattening, defined by flatness score (FS) was statistically significantly greater in the preterm group than in the term group at T1-T4 (p < 0.05). In both groups, OCLR improved gradually over time. There were no instances, in either group, of severe DP and no moderate DP after T2. Results indicate that DP affects preterm and full-term children almost equally during the first three years of life, and cranial asymmetry resolves at a similar rate in both preterm and term groups after three months of corrected age. Preterm infants present with more occipital flattening than full-term children.

Accuracy of measurements used to quantify cranial asymmetry in deformational plagiocephaly.

OBJECTIVE: Various measurements are used to quantify cranial asymmetry in deformational plagiocephaly (DP), but studies validating cut-off values and comparing the accuracy of such measurements are lacking. In this study, we compared the accuracy of four different measurements in classifying children with and without DP diagnosed by visual assessment, and sought to determine their optimal cut-off values. STUDY DESIGN: Two experts rated 407 3D craniofacial images of children aged between 3 and 36 months old using the Argenta classification. We then measured the following asymmetry-related variables from the images: Oblique Cranial Length Ratio (OCLR), Diagonal Difference (DD), Posterior Cranial Asymmetry Index (PCAI), and weighted Asymmetry Score (wAS). We created receiver operating characteristic curves to evaluate the accuracy of these variables. RESULTS: All variables performed well, but OCLR consistently provided the best discrimination in terms of area under the curve values. Subject's age had no clear effect on the cut-off values for OCLR, PCAI, and wAS; however, the cut-off for DD increased monotonically with age. When subjects with discrepant expert ratings were excluded, the optimal cut-off values for DP (Argenta class ≥ 1) across all age-groups were 104.0% for OCLR (83% sensitivity, 97% specificity), 10.5% for PCAI (90% sensitivity, 90% specificity), and 24.5 for wAS (88% sensitivity, 90% specificity). CONCLUSION: We recommend using OCLR as the primary measurement, although PCAI and wAS may also be useful in monitoring cranial asymmetry. The threshold of relative asymmetry required for a deformation to appear clinically significant is not affected by the child's age, and DD has no additional utility in monitoring DP compared to using only OCLR.

Association between diet quality measured by the Healthy Food Intake Index and later risk of gestational diabetes-a secondary analysis of the RADIEL trial.

The aim of this study was to find the association between adherence to the Nordic Nutrition Recommendations (NNR) and glucose metabolism. Participants were 137 pregnant obese women or women with a history of gestational diabetes (GDM) from the Finnish Gestational Diabetes Prevention Study. Adherence to the NNR was assessed by the Healthy Food Intake Index (HFII) calculated from the first trimesters' food frequency questionnaires. Higher HFII scores reflected higher adherence to the NNR (score range 0-17). Regression models with linear contrasts served for the main analysis. The mean HFII score was 10.0 (s.d. 2.8). The odds for GDM decreased toward the higher HFII categories (P=0.067). Fasting glucose (FG) and 2hG concentrations showed inverse linearity across the HFII categories (P(FG)=0.030 and P(2hG)=0.028, adjusted for body mass index, age and GDM/pregnancy history). Low adherence to the NNR is associated with higher antenatal FG and 2hG concentrations and possibly GDM.

Association between diet quality measured by the Healthy Food Intake Index and later risk of gestational diabetes-a secondary analysis of the RADIEL trial.

This corrects the article DOI: 10.1038/ejcn.2016.275.

The effect of dietary counselling on food intakes in pregnant women at risk for gestational diabetes: a secondary analysis of a randomised controlled trial RADIEL.

BACKGROUND/OBJECTIVES: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM may be prevented by improving the diets of pregnant women. The objective of this study was to evaluate the effect of dietary counselling on the diets of pregnant women at GDM risk. SUBJECTS/METHODS: This study was a secondary analysis of a randomised controlled trial the Finnish gestational diabetes prevention study (RADIEL) in which pre-pregnant and pregnant women with previous GDM or BMI ⩾30 kg/m(2) were allocated into two groups, namely the control and the intervention groups. The control group received standard antenatal dietary counselling according to the Finnish Nutrition Recommendations. The intervention group participated in one individual dietary counselling session and one group dietary counselling session in addition to the standard counselling. This study included women who were recruited during pregnancy. To assess changes in food intake, food-intake questionnaires were collected during the first and the second trimester of pregnancy. Bootstrap type analysis of covariance was used, and 242 participants were included in the final analysis to study changes in food intake. RESULTS: The intakes of low-fat cheese (baseline adjusted mean 0.09 times/day; 95% confidence interval (CI) 0.07, 0.24; P=0.040) and fish (baseline adjusted mean 0.28 times per week; 95% CI 0.08, 0.49; P=0.011) showed a significant increase in the intervention group compared with the control group. CONCLUSIONS: This study showed that dietary counselling in early pregnancy can lead to modest dietary improvements in pregnant women at GDM risk.

Cranial shape, size and cervical motion in normal newborns.

BACKGROUND: Deformational plagiocephaly (DP) and torticollis are commonly seen in infants and they often co-occur, but little is known of the prevalence and relationship of these conditions in the immediate newborn period. No previous studies focusing on the relationship between cranial shape and cervical motion in newborns can be found. OBJECTIVES: Determining the incidence rates and characteristics of DP and torticollis and examining the relationship between cervical range of motion (ROM), cranial size and cranial shape in neonates. METHODS: A single-center, descriptive cross-sectional study including 155 healthy neonates was conducted. Participants were examined during their birth hospitalization. Oblique Cranial Length Ratio (OCLR) and Cephalic Index (CI), indicating cranial asymmetry and shape, were measured from standardized digital photographs with a computer-based cephalometric method. Cervical ROM was measured with goniometry. RESULTS: 7.7% of the newborns had DP and 3.9% had torticollis. 46.4% presented lesser cervical imbalances. DP was associated with gestational diabetes (adjusted OR 5.6; p<0.01) and vacuum assisted delivery (adjusted OR 6.8; p<0.01), but not at all with torticollis. CI correlated strongly with cervical ROM in all directions, while no definite association between cranial asymmetry and cervical motion could be found. CONCLUSIONS: DP and torticollis are common and minor cervical imbalances very common in normal newborns. Our results support the theory that in most cases neither DP nor torticollis is congenital, but rather develops and worsens synergistically in early infancy. Still, although no direct association between DP and torticollis was found, cranial shape is linked to cervical motion at birth.

Wheezing illness and re-hospitalization in the first two years of life after neonatal respiratory distress syndrome.

OBJECTIVES: To determine the impact of respiratory distress syndrome (RDS) on wheezing illnesses and re-hospitalizations in children as old as 2 years of age. STUDY DESIGN: We observed 2 geographically defined cohorts of children with RDS born after 26 weeks of gestation during 1990 to 1995 and 1996 to 1999 and gestationally paired control subjects. Recurrent wheezing illness and the re-hospitalizations caused by a respiratory condition were recorded. RESULTS: In the first year of life, 47 of 224 infants with RDS and 18 of 224 control subjects born in 1990 to 1995 had recurrent wheezing illness (P <.005) compared with 21 of 109 infants with RDS and 14 of 109 control subjects in the latter cohort (P=.27). A higher number of infants with RDS were readmitted to the hospital (25% versus 13%, P=.002) in the former period, and they spent more days in hospital during both periods. The frequencies of wheezing remained constant in the second year of life, but hospital admissions decreased. Siblings at home, male sex, and bronchopulmonary dysplasia were additional risk factors of wheezing illnesses. CONCLUSION: RDS increases the incidence of wheezing illnesses during the first 2 years of life. Changes in the management of RDS during the 1990s was associated with a decreased incidence of subsequent RDS-associated respiratory morbidity.

Brain single photon emission computed tomography at term age for predicting cerebral palsy after preterm birth.

In order to assess the predictive value of neonatal brain perfusion with single photon emission computed tomography (SPET) with regard to neuromotor outcome at a corrected age of 18 months, 34 infants with birth weight <1,500 g and gestation age <34 weeks underwent brain technetium-99m ethylcysteinate dimer (99Tc(m)-ECD) SPET at term age. The perfusion defects were estimated by visual interpretation. Consecutive semiquantitative assessment was made in 26 cases and reference values for the tracer were collected from images of 17 preterm infants with normal outcome after the follow-up period. Relative regional cortical (frontal, sensorimotor, parietal and occipital), cerebellar and thalamic perfusion levels were evaluated in middle sagittal slices and hemispheric asymmetries in transaxial slices. Perfusion defects predicted cerebral palsy (CP) (n = 11) with 82% sensitivity, 70% specificity and 74% accuracy, the corresponding figures for ultrasound (US) being 73, 83 and 79%, respectively. The sensitivity of SPET in predicting moderate or severe CP (n = 7) was 100% and the specificity 67%, the corresponding figures for US being 71% and 74%, respectively. Brain SPET seems to identify the most severe forms of CP in preterm infants very well at term age, but cannot identify all mild ones. In addition to a low specificity, the radiation exposure restricts usefulness of the method for clinical purposes.

Magnetic resonance imaging at term and neuromotor outcome in preterm infants.

In order to evaluate the value of neonatal brain magnetic resonance imaging (MRI) for predicting neuromotor outcome in very low birthweight (VLBW) preterm infants, 51 such infants with gestational age <34 wk underwent brain MRI at term age. Myelination, parenchymal lesions (haemorrhage, leukomalacia, infarction, reduction of white matter), parenchymal lesions without subependymal haemorrhage, ventricular/brain ratios and widths of the extracerebral spaces were assessed. The MRI findings were compared with cranial ultrasound (US) performed at term. Infants' neuromotor development was followed up until 18 mo corrected age. Parenchymal lesions seen in MRI at term predicted cerebral palsy (CP) with 100% sensitivity and 79% specificity, the corresponding figures for US being 67% and 85%, respectively. Parenchymal lesions in MRI, excluding subependymal haemorrhages, predicted CP with a sensitivity of 82% and a specificity of 97%, the corresponding figures for US being 58% and 100%, respectively. Delayed myelination, ventricular/brain ratios and widths of the extracerebral spaces failed to predict CP. Term age is a good time for neuroradiological examinations in prematurely born high-risk infants. Parenchymal lesions seen in MRI are reliable predictors for CP.