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Journal of Pediatrics, The

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Are Outcomes of Extremely Preterm Infants Improving? Impact of Bayley Assessment on Outcomes - 24/07/12

Doi : 10.1016/j.jpeds.2012.01.057 
Betty R. Vohr, MD 1, ⁎ , Bonnie E. Stephens, MD 1, Rosemary D. Higgins, MD 2, Carla M. Bann, PhD 3, Susan R. Hintz, MD, MS Epi 4, Abhik Das, PhD 5, Jamie E. Newman, PhD, MPH 3, Myriam Peralta-Carcelen, MD, MPH 6, Kimberly Yolton, PhD 7, Anna M. Dusick, MD, FAAP 8, Patricia W. Evans, MD 9, Ricki F. Goldstein, MD 10, Richard A. Ehrenkranz, MD 11, Athina Pappas, MD 12, Ira Adams-Chapman, MD 13, Deanne E. Wilson-Costello, MD 14, Charles R. Bauer, MD 15, Anna Bodnar, MD 16, Roy J. Heyne, MD 17, Yvonne E. Vaucher, MD, MPH 18, Robert G. Dillard, MD 19, Michael J. Acarregui, MD 20, Elisabeth C. McGowan, MD 21, Gary J. Myers, MD 22, Janell Fuller, MD 23

Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

  A list of members of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network is available at www.jpeds.com (Appendix).

1 Department of Pediatrics, Women & Infants’ Hospital, Brown University, Providence, RI 
2 Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 
3 Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC 
4 Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 
5 Statistics and Epidemiology Unit, RTI International, Rockville, MD 
6 Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL 
7 Department of Pediatrics, University of Cincinnati, Cincinnati, OH 
8 Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 
9 Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX 
10 Department of Pediatrics, Duke University, Durham, NC 
11 Department of Pediatrics, Yale University School of Medicine, New Haven, CT 
12 Department of Pediatrics, Wayne State University, Detroit, MI 
13 Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA 
14 Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH 
15 University of Miami Miller School of Medicine, Miami, FL 
16 Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City, UT 
17 Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 
18 Division of Neonatology, University of California San Diego, La Jolla, CA 
19 Wake Forest University School of Medicine, Winston-Salem, NC 
20 Department of Pediatrics, University of Iowa, Iowa City, IA 
21 Department of Pediatrics, Division of Newborn Medicine, Floating Hospital for Children, Tufts Medical Center, Boston, MA 
22 University of Rochester School of Medicine and Dentistry, Rochester, NY 
23 University of New Mexico Health Sciences Center, Albuquerque, NM 

Reprint requests: Betty R. Vohr, MD, Women & Infant’s Hospital, 101 Dudley Street, Providence, RI 02905.

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.

Le texte complet de cet article est disponible en PDF.

Mots-clés : Bayley II, Bayley III, BPD, CA, Cog, CP, ELBW, GA, GMFCS, IVH, MDI, NDI, NEC, NRN, PDI, PT, PVL, ROP


Plan


 Supported by grants from the National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Data collected at participating sites of the National Institute of Child Health and Human Development’s Neonatal Research Network were transmitted to RTI International, the data coordinating center for the network, which stored, managed, and analyzed the data for this study. The authors declare no conflicts of interest.


© 2012  Mosby, Inc. Tous droits réservés.
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Vol 161 - N° 2

P. 222 - août 2012 Retour au numéro
Article précédent Article précédent
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