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

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 & 5 others Robert G. Dillard, Michael J. Acarregui, Elisabeth C. McGowan, Gary J. Myers, Janell Fuller

Research output: Contribution to journalArticle

131 Citations (Scopus)

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.

Original languageEnglish (US)
JournalJournal of Pediatrics
Volume161
Issue number2
DOIs
StatePublished - Aug 2012

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Extremely Premature Infants
Extremely Low Birth Weight Infant
Language
Outcome Assessment (Health Care)
Child Development
National Institute of Child Health and Human Development (U.S.)
Neonatal Intensive Care Units
Disabled Children
Multivariate Analysis
Regression Analysis
Research

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Vohr, B. R., Stephens, B. E., Higgins, R. D., Bann, C. M., Hintz, S. R., Das, A., ... Fuller, J. (2012). Are outcomes of extremely preterm infants improving? Impact of Bayley assessment on outcomes. Journal of Pediatrics, 161(2). https://doi.org/10.1016/j.jpeds.2012.01.057

Are outcomes of extremely preterm infants improving? Impact of Bayley assessment on outcomes. / Vohr, Betty R.; Stephens, Bonnie E.; Higgins, Rosemary D.; Bann, Carla M.; Hintz, Susan R.; Das, Abhik; Newman, Jamie E.; Peralta-Carcelen, Myriam; Yolton, Kimberly; Dusick, Anna M.; Evans, Patricia W.; Goldstein, Ricki F.; Ehrenkranz, Richard A.; Pappas, Athina; Adams-Chapman, Ira; Wilson-Costello, Deanne E.; Bauer, Charles R.; Bodnar, Anna; Heyne, Roy J.; Vaucher, Yvonne E.; Dillard, Robert G.; Acarregui, Michael J.; McGowan, Elisabeth C.; Myers, Gary J.; Fuller, Janell.

In: Journal of Pediatrics, Vol. 161, No. 2, 08.2012.

Research output: Contribution to journalArticle

Vohr, 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 2012, 'Are outcomes of extremely preterm infants improving? Impact of Bayley assessment on outcomes', Journal of Pediatrics, vol. 161, no. 2. https://doi.org/10.1016/j.jpeds.2012.01.057
Vohr, Betty R. ; Stephens, Bonnie E. ; Higgins, Rosemary D. ; Bann, Carla M. ; Hintz, Susan R. ; Das, Abhik ; Newman, Jamie E. ; Peralta-Carcelen, Myriam ; Yolton, Kimberly ; Dusick, Anna M. ; Evans, Patricia W. ; Goldstein, Ricki F. ; Ehrenkranz, Richard A. ; Pappas, Athina ; Adams-Chapman, Ira ; Wilson-Costello, Deanne E. ; Bauer, Charles R. ; Bodnar, Anna ; Heyne, Roy J. ; Vaucher, Yvonne E. ; Dillard, Robert G. ; Acarregui, Michael J. ; McGowan, Elisabeth C. ; Myers, Gary J. ; Fuller, Janell. / Are outcomes of extremely preterm infants improving? Impact of Bayley assessment on outcomes. In: Journal of Pediatrics. 2012 ; Vol. 161, No. 2.
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AU - Vohr, Betty R.

AU - Stephens, Bonnie E.

AU - Higgins, Rosemary D.

AU - Bann, Carla M.

AU - Hintz, Susan R.

AU - Das, Abhik

AU - Newman, Jamie E.

AU - Peralta-Carcelen, Myriam

AU - Yolton, Kimberly

AU - Dusick, Anna M.

AU - Evans, Patricia W.

AU - Goldstein, Ricki F.

AU - Ehrenkranz, Richard A.

AU - Pappas, Athina

AU - Adams-Chapman, Ira

AU - Wilson-Costello, Deanne E.

AU - Bauer, Charles R.

AU - Bodnar, Anna

AU - Heyne, Roy J.

AU - Vaucher, Yvonne E.

AU - Dillard, Robert G.

AU - Acarregui, Michael J.

AU - McGowan, Elisabeth C.

AU - Myers, Gary J.

AU - Fuller, Janell

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N2 - 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.

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