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Are outcomes of extremely preterm infants improving? Impact of Bayley assessment on outcomes.

CPQCC Publication
TitleAre outcomes of extremely preterm infants improving? Impact of Bayley assessment on outcomes.
Publication TypeJournal Article
Year of Publication2012
AuthorsVohr BR, Stephens BE, Higgins RD, Bann CM, Hintz SR, Das A, Newman JE, Peralta-Carcelen M, Yolton K, Dusick AM, Evans PW, Goldstein RF, Ehrenkranz RA, Pappas A, Adams-Chapman I, Wilson-Costello DE, Bauer CR, Bodnar A, Heyne RJ, Vaucher YE, Dillard RG, Acarregui MJ, McGowan EC, Myers GJ, Fuller J
Corporate AuthorsEunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
JournalJ Pediatr
Volume161
Issue2
Pagination222-8.e3
Date Published2012 Aug
ISSN1097-6833
KeywordsCognition, Developmental Disabilities, Gestational Age, Humans, Infant, Infant, Extremely Low Birth Weight, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases, Language Development, Neuropsychological Tests
Abstract

OBJECTIVES: To compare 18- to 22-month cognitive scores and neurodevelopmental impairment (NDI) in 2 time periods using the National Institute of Child Health and Human Development's Neonatal Research Network assessment of extremely low birth weight infants with the Bayley Scales of Infant Development, Second Edition (Bayley II) in 2006-2007 (period 1) and using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), with separate cognitive and language scores, in 2008-2011 (period 2).

STUDY DESIGN: Scores were compared with bivariate analysis, and regression analyses were run to identify differences in NDI rates.

RESULTS: Mean Bayley III cognitive scores were 11 points higher than mean Bayley II cognitive scores. The NDI rate was reduced by 70% (from 43% in period 1 to 13% in period 2; P < .0001). Multivariate analyses revealed that Bayley III contributed to a decreased risk of NDI by 5 definitions: cognitive score <70 and <85, cognitive or language score <70; cognitive or motor score <70, and cognitive, language, or motor score <70 (P < .001).

CONCLUSION: Whether the Bayley III is overestimating cognitive performance or whether it is a more valid assessment of emerging cognitive skills than the Bayley II is uncertain. Because the Bayley III identifies significantly fewer children with disability, it is recommended that all extremely low birth weight infants be offered early intervention services at the time of discharge from the neonatal intensive care unit, and that Bayley scores be interpreted with caution.

DOI10.1016/j.jpeds.2012.01.057
Alternate JournalJ Pediatr
PubMed ID22421261
PubMed Central IDPMC3796892
Grant ListU10 HD027856 / HD / NICHD NIH HHS / United States
U10 HD021373 / HD / NICHD NIH HHS / United States
UG1 HD053089 / HD / NICHD NIH HHS / United States
U10 HD040461 / HD / NICHD NIH HHS / United States
U10 HD027904 / HD / NICHD NIH HHS / United States
M01 RR000997 / RR / NCRR NIH HHS / United States
U10 HD053089 / HD / NICHD NIH HHS / United States