Are Outcomes of Extremely Preterm Infants Improving? Impact of Bayley Assessment on Outcomes

Overview

Journal J Pediatr

Specialty Pediatrics

Date 2012 Mar 17

PMID 22421261

Citations 99

Authors

Betty R Vohr

Bonnie E Stephens

Rosemary D Higgins

Carla M Bann

Susan R Hintz

Abhik Das

Jamie E Newman

Myriam Peralta-Carcelen

Kimberly Yolton

Anna M Dusick

Patricia W Evans

Ricki F Goldstein

Richard A Ehrenkranz

Athina Pappas

Ira Adams-Chapman

Deanne E Wilson-Costello

Charles R Bauer

Anna Bodnar

Roy J Heyne

Yvonne E Vaucher

Robert G Dillard

Michael J Acarregui

Elisabeth C McGowan

Gary J Myers

Janell Fuller

Affiliations

Soon will be listed here.

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.

Citing Articles

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