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Comparison of B ayley‐2 and B ayley‐3 scores at 18 months in term infants following neonatal encephalopathy and therapeutic hypothermia
Author(s) -
Jary Sally,
Whitelaw Andrew,
Walløe Lars,
Thoresen Marianne
Publication year - 2013
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.12208
Subject(s) - medicine , encephalopathy , gestational age , group b , hypothermia , pediatrics , neonatal encephalopathy , pregnancy , biology , genetics
Aim Neuroprotection trials for neonatal encephalopathy use moderate or severe disability as an outcome, with the B ayley S cales of I nfant D evelopment, Second Edition ( B ayley‐2) I ndex scores of <70 as part of the criteria. The B ayley S cales of I nfant and T oddler, 3rd D evelopment, Third Edition ( B ayley‐3) have superseded B ayley‐2 and yield higher than expected scores in typically developing and high‐risk infants. The aim of this study, therefore, was to compare B ayley‐2 scores and B ayley‐3 scores in term‐born infants surviving neonatal encephalopathy treated with hypothermia. Method Sixty‐one term‐born infants (37 males, 24 females; median gestational age at birth 40wks, range 36–42wks; median birthweight 3280g, range 2295–5050) following neonatal encephalopathy and hypothermia had contemporaneous assessment at 18 months using the B ayley‐2 and B ayley‐3. Results The median B ayley‐3 C ognitive C omposite score was 7 points higher than the median B ayley‐2 M ental D evelopmental I ndex ( MDI ) score and the median B ayley‐3 M otor C omposite score was 18 points higher than the median B ayley‐2 P sychomotor D evelopmental I ndex ( PDI ) score. Ten children had a B ayley‐2 MDI of <70; only three children had B ayley‐3 combined C ognitive/ L anguage scores of <70. Eleven children had B ayley‐2 PDI scores of <70 and four had modified B ayley‐3 M otor C omposite scores of <70. Applying regression equations to B ayley‐3 scores adjusted rates of severe delay to similar proportions found using B ayley‐2 scores. Interpretation Fewer children were classified with severe delay using the B ayley‐3 than the B ayley‐2, which prohibits direct comparison of scores. Increased B ayley‐3 cut‐off thresholds for classifying severe disability are recommended when comparing studies in this clinical group using B ayley‐2 scores.