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Research ArticlePediatrics

Comparison of Papile versus Laterality-Based Al-Abdi System to Predict Neurodevelopmental Impairment in Extreme Preterm Infants after Severe Germinal Matrix Hemorrhage–Intraventricular Hemorrhage: A Retrospective Comparative Observational Study

S. Desai, G. Athalye-Jape, S. Madhala, W. Tee, M. Sharp, E. Nathan, D. Shrestha and S. Patole
American Journal of Neuroradiology March 2022, 43 (3) 486-492; DOI: https://doi.org/10.3174/ajnr.A7434
S. Desai
aFrom the Neonatal Directorate (S.D., G.A.-J., M.S., D.S., S.P.)
dPerth Children’s Hospital (D.S, S.M., W.T., M.S.), Perth, Western Australia, Australia
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G. Athalye-Jape
aFrom the Neonatal Directorate (S.D., G.A.-J., M.S., D.S., S.P.)
eSchool of Medicine (G.A.-J., M.S., S.P.)
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S. Madhala
bDepartment of Radiology (S.M., W.T.)
dPerth Children’s Hospital (D.S, S.M., W.T., M.S.), Perth, Western Australia, Australia
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W. Tee
bDepartment of Radiology (S.M., W.T.)
dPerth Children’s Hospital (D.S, S.M., W.T., M.S.), Perth, Western Australia, Australia
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M. Sharp
aFrom the Neonatal Directorate (S.D., G.A.-J., M.S., D.S., S.P.)
dPerth Children’s Hospital (D.S, S.M., W.T., M.S.), Perth, Western Australia, Australia
eSchool of Medicine (G.A.-J., M.S., S.P.)
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E. Nathan
cWomen and Infants Research Foundation (E.N.), King Edward Memorial Hospital for Women, Perth, Western Australia, Australia
fDivision of Obstetrics and Gynaecology (E.N.), University of Western Australia, Perth, Western Australia, Australia
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D. Shrestha
aFrom the Neonatal Directorate (S.D., G.A.-J., M.S., D.S., S.P.)
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S. Patole
aFrom the Neonatal Directorate (S.D., G.A.-J., M.S., D.S., S.P.)
eSchool of Medicine (G.A.-J., M.S., S.P.)
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Article Figures & Data

Figures

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  • FIG 1.
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    FIG 1.

    Al-Abdi score image. LOGIQ E9 indicates ultrasound machine that was used to capture the image.

  • FIG 2.
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    FIG 2.

    Study flow diagram.

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    FIG 3.

    ROC AUC for the Al-Abdi versus the Papile systems.

  • FIG 4.
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    FIG 4.

    ROC AUC comparing Papile and Al-Abdi models including GA, BW z score, oxygen at 36 weeks, and socioeconomic status.

Tables

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    Table 1:

    Demographic characteristics of the study population (n = 83) followed up for neurodevelopmental assessments compared with those who died (n = 60) or were lost to follow-up (n = 8)

    CharacteristicFollowed Up (n = 83)Not Followed Up (n = 68)P Value
    GA (median) (IQR) (wk)26.3 (24.5–28.4; 23.1–31.5)24.3 (23.3–26.6; 22.3–31.5)<.001
    BW (median) (IQR) (g)890 (680–1200; 481–1985)730 (606–1016; 420–2020).015
    Male sex46 (55.4%)37 (54.4%).901
    IUGR4 (4.8%)7 (10.3%).223
    Multiple birth16 (19.5%)11 (16.4%).626
    Inborn72 (86.7%)63 (92.6%).241
    Maternal antenatal steroids
     None11 (13.3%)12 (17.6%).720
     Incomplete34 (41.0%)28 (41.2%)
     Complete38 (45.8%)28 (41.2%)
    MgSO422 (26.5%)15 (22.1%).527
    Maternal chorioamnionitis22 (26.5%)10 (14.7%).078
    Pneumothorax13 (15.7%)16 (23.5%).222
    Inotropic agent13 (15.7%)15 (22.1%).314
    EOS11 (13.3%)7 (10.3%).577
    PDA treated49 (59.0%)28 (41.2%).029
    NEC3 (3.6%)1 (1.5%).414
    Postnatal steroids41 (49.4%)27 (39.7%).234
    ROP treated4 (4.8%)1 (1.5%).379
    • Note:—IQR indicates interquartile range; IUGR, intrauterine growth restriction; MgSO4, magnesium sulfate; PDA, patent ductus arteriosus; NEC, necrotising enterocollitis; EOS, early onset sepsis; ROP, retinopathy of prematurity.

    • View popup
    Table 2:

    Distribution of infants with IVH 3 or 4 Papile grading, with their corresponding Al-Abdi score and impairment showing subtotals and percentages for each Papile grade

    Scoring System (No.)Impairment
    PapileAbdiNoneMildModerateSevere
     Grade 3: 40 9: 21100
     10: 21100
     11: 54010
     12: 31161014
    22 (61.1%)12 (63.2%)2 (15.4%)4 (26.7%)
     Grade 4: 43 16: 32001
     17: 41021
     18: 74102
     19: 43010
     20: 51121
     21: 10001
     22: 10010
     24: 41012
     25: 20011
     26: 32100
     28: 10100
     29: 40121
     30: 30111
     35: 10100
    14 (38.9%)7 (36.8%)11 (84.6%)11 (73.3%)
    • View popup
    Table 3:

    AUC, sensitivity, specificity, and correct classification comparisons of Papile grade 4 and corresponding Al-Abdi scores in the prediction of moderate-to-severe disability

    AUC95% CIGrade/Score CutoffSensitivitySpecificityCorrectly Classified
    Papile
     0.7020.601–0.802478.57%61.82%67.47%
    Abdi
     0.7230.609–0.8351678.57%61.82%67.47%
    1775.0%65.45%68.67%
    1864.29%67.27%66.27%
    1957.14%76.36%69.88%
    2053.57%81.82%72.29%
    2142.86%85.45%71.08%
    2239.29%85.45%69.88%
    2435.71%85.45%68.67%
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American Journal of Neuroradiology: 43 (3)
American Journal of Neuroradiology
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1 Mar 2022
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S. Desai, G. Athalye-Jape, S. Madhala, W. Tee, M. Sharp, E. Nathan, D. Shrestha, S. Patole
Comparison of Papile versus Laterality-Based Al-Abdi System to Predict Neurodevelopmental Impairment in Extreme Preterm Infants after Severe Germinal Matrix Hemorrhage–Intraventricular Hemorrhage: A Retrospective Comparative Observational Study
American Journal of Neuroradiology Mar 2022, 43 (3) 486-492; DOI: 10.3174/ajnr.A7434

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Comparison of Papile versus Laterality-Based Al-Abdi System to Predict Neurodevelopmental Impairment in Extreme Preterm Infants after Severe Germinal Matrix Hemorrhage–Intraventricular Hemorrhage: A Retrospective Comparative Observational Study
S. Desai, G. Athalye-Jape, S. Madhala, W. Tee, M. Sharp, E. Nathan, D. Shrestha, S. Patole
American Journal of Neuroradiology Mar 2022, 43 (3) 486-492; DOI: 10.3174/ajnr.A7434
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