Developmental trajectories of infants born at less than 30 weeks’ gestation on the Bayley-III Scales

Durrant, Chloe; Wong, Hilary; Cole, Tim J.; Hutchon, Betty; Collier, L; Wright, Anna W.; George, Cara; Haan, Michelle de; Ceballos, Angela Huertas

doi:10.1136/archdischild-2019-317810

Cited by 12 publications

(9 citation statements)

References 20 publications

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“…Studies evaluating developmental trajectories in preterm children often have focused on specific components of development, like cognitive, behavioral, or social problems (5,10,13,(18)(19)(20). However, a composite outcome score combining different domains provides a general insight in the amount and kind of disabilities of preterm born children.…”

Section: Introductionmentioning

confidence: 99%

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Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study

et al. 2021

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Aim: Long-term outcome data in preterm children is often limited to cross-sectional measurement of neurodevelopmental impairment (NDI) at the corrected age of 24-36 months. However, impairments may only become overt during childhood or resolve with time, and individual trajectories in outcome over time may vary. The primary aim of this study was to describe NDI in very preterm born children at three subsequent ages of 2, 5, and 8 years of age. As a secondary aim, a longitudinal analysis was performed on the individual longitudinal trajectories in NDI from 2 to 8 years of age.Methods: Single-center prospective cohort study including children born between 1990 and 2011 below 30 weeks' gestation and followed into 2019. The outcome measurement was NDI assessed at 2, 5, and 8 years of age. NDI is a composite score that includes cognitive, neurological, visual, and auditory functions, in which problems were categorized as none, mild, moderate, or severe. Cognitive function measured as total DQ/IQ score was assessed by standardized psychometric tests. Neurological, visual, and auditory functions were assessed by the neonatologist.Results: In total, 921 children were eligible for follow-up, of whom 726 (79%) children were assessed. No NDI was seen in 54, 54, and 62%, mild NDI was seen in 31, 36, and 30%, and moderate-to-severe NDI was seen in 15, 9.2, and 8.6% of the children at 2, 5, and 8 years, respectively. From 2 to 8 years, 63% of the children remained in the same NDI category, 20% of the children improved to a better NDI category, and 17% deteriorated toward a worse NDI category. No differences were found in baseline characteristics of infants that improved or deteriorated. Extreme prematurity, male gender and low parental education were associated with worse NDI status at all time points. Although we observed considerable individual variation over time in NDI status, the course of the trajectories in NDI were not associated with gestation, gender, and parental education.Conclusions: Continued follow-up until school life is essential in order to provide optimal and individually focused referrals and care when needed.

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Section: Introductionmentioning

confidence: 99%

“…As the impact of developmental impairment may be different at different stages of development, there is increasing interest in studying development as a dynamic process ( 9 , 10 ). Currently available outcome data are often limited to cross-sectional measurements in toddlerhood, but longitudinal follow-up of children is important.…”

Section: Introductionmentioning

confidence: 99%

Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study

et al. 2021

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“…The two-time-point trends or multiple-time-point trajectories based on mean cognitive scores may have limitations for individualized outcome prediction. Among the few studies investigating cognitive trajectories with individual variability during the first 2 years of life [9, 10], one concluded preterm infants with neurological abnormalities or low maternal education were at risk of decline in MDI trajectories [10]. These findings highlight the influence of medical and sociodemographic risks on the trends of cognitive development in preterm infants.…”

Section: Discussionmentioning

confidence: 99%

“…Cognitive development in preterm infants is a dynamic process [9, 10]. Although the prediction of cognitive risk at school age might improve with age as the diagnostic accuracy improves [4], earlier and more accurate predictions of cognitive outcomes may be obtained from the use of early-life mental developmental trajectories than from the use of a single-time-point cognitive score.…”

Section: Introductionmentioning

confidence: 99%

Early Mental Trajectories Predict Different Cognitive Levels at School Age in Very Preterm Children

Wang

Lin

et al. 2022

Neonatology

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Introduction: Early identification of preterm children at high risk of intellectual disability (intelligence quotient [IQ] <70) or borderline intelligence (IQ = 70–84) is critical for different early intervention. We investigated whether early-life mental trajectories predict intellectual disability and borderline intelligence, respectively, among school-age preterm children. Methods: A multicenter study recruited preterm infants born at <32 weeks’ gestation between 2001 and 2014 in Taiwan who underwent mental assessments (Bayley Scales of Infant Development) at corrected ages 6, 12, and 24 months and IQs at age 5.5 years. Mental trajectories from ages 6 to 24 months determined using group-based trajectory modeling were employed to predict intellectual disability and borderline intelligence, respectively. Model fit was assessed using the area under the receiver operating characteristic curve (AUROC) and Akaike information criterion (AIC). Results: Among the 1,680 children enrolled, three mental trajectories were identified: high-stable (59.7%), high-declining (35.3%), and low-declining (5.0%), in which the borderline-intelligence/intellectual-disability rate was 14.1%/1.5%, 36.1%/13.7%, and 10.7%/82.1%, respectively. Compared with children with normal intelligence, the low-declining trajectory had 37.7-fold higher odds (95% confidence interval [CI], 26.3–48.1) for intellectual disability, and the high-declining trajectory had 4.4-fold higher odds (95% CI, 3.1–6.1) for borderline intelligence. Compared to the models with risk factors alone (AIC 1,791.2), the models that included both risk factors and trajectory groups had better overall performance (AIC 1,419.8) and increased prediction power for intelligence outcomes: low-declining trajectory for intellectual disability (AUROC increased from 0.81 to 0.92) and high-declining trajectory for borderline intelligence (AUROC increased from 0.68 to 0.75). Conclusions: Early-life mental trajectories help identify preterm children at risk of intellectual disability and borderline intelligence, respectively, at school age for timely intervention.

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“…The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III), is an internationally tool used to assess infant development in different aspects: cognition, receptive and expressive language, fine and gross motor skills, and socioemotional and adaptive behavior 10 . This scale has proven to be a useful tool to be applied to infants without indications of risks or associated pathologies in South America, 11,12 as well as premature infants 13 and children at risk of delayed motor development 14 . It is a tool used for the identification of developmental delays, description of the development profile, and analysis of risk factors in relation to development aspects 9 .…”

Section: Introductionmentioning

confidence: 99%

Development of infants presented with congenital syphilis in their first months of life

et al. 2021

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Developmental trajectories of infants born at less than 30 weeks’ gestation on the Bayley-III Scales

Cited by 12 publications

References 20 publications

Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study

Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study

Early Mental Trajectories Predict Different Cognitive Levels at School Age in Very Preterm Children

Development of infants presented with congenital syphilis in their first months of life

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