The Lacey Assessment of Preterm Infants

Abstract

Background and Aim: The Lacey Assessment of Preterm Infants (LAPI) is reported to have low sensitivity but high specificity to predict neurological function. The study objective was to find the predictive validity of the LAPI of preterm infants (LAPIs) to predict neuromotor outcomes of infants born preterm at the corrected age of 3–4 months. Materials and Methods: In this prospective cohort study, infants born below 35 weeks' gestation were assessed using the LAPI before their discharge from the neonatal intensive care unit. Data were collected from Latifa Hospital, Dubai. Outcome assessment was done between 3 and 4 months corrected age using Prechtl's general movement assessment (GMA) and the Test of infant motor performance (TIMP). Results: A total of 125 infants completed the tests (45.6% females); their mean gestational age was 30.28 (standard deviation 2.59) weeks. LAPI showed 87.50% sensitivity (95% confidence interval [CI] =47.35%–99.68%), 96.58% specificity (95% CI = 91.48%–99.06%), and 99.12% negative predictive value (95% CI = 94.75%–99.86%) in predicting fidgety movements in the GMA. The specificity and negative predictive value of the LAPI to predict the motor outcome in the TIMP was 98.06% (95% CI = 93.16%–99.76%) and 88.60% (95% CI = 84.57%–91.67%) respectively whereas sensitivity was 40.91% (95% CI = 20.71%–63.65%). Developmental score in the LAPI showed a weak correlation (P = 0.02, r = 0.20) with the TIMP score. Conclusion: The results suggest that the LAPI can be used to reliably predict neurological function for infants born preterm at 3–4 months corrected age. LAPI can be used as a discharge assessment tool in neonatal units to identify candidates for early intervention services.