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Predicting developmental outcomes in very preterm infants: validity of a neonatal neurobehavioral assessment
Author(s) -
Harijan Pooja,
Beer Charlotte,
Glazebrook Cris,
Israel Chrissie,
Marlow Neil,
Whitelaw Andrew,
Johnson Samantha
Publication year - 2012
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2012.02663.x
Subject(s) - bayley scales of infant development , irritability , medicine , psychomotor learning , gestational age , pediatrics , alertness , construct validity , predictive validity , cognition , psychometrics , pregnancy , psychiatry , clinical psychology , genetics , biology
Aim: This study explored inter‐rater reliability, discriminative, construct and predictive validity of the Neurobehavioral Assessment of the Preterm Infant (NAPI) in a gestational‐age‐based cohort. Methods: The NAPI was conducted at 35 weeks post‐menstrual age for 170 infants born <32 weeks. Cognitive and motor development was assessed at 2 years using the Mental Development Index (MDI) and Psychomotor Development Index (PDI) of Bayley Scales of Infant Development‐II for 159 infants. Results: Only NAPI motor and irritability scores were significantly different between very (29–3 w) and extremely preterm (<28 w) infants. Results regarding construct validity were variable: there were weak correlations between NAPI motor scores and gestational age (r = −0.23; p = 0.003), days in NICU (r = −0.24; p = 0.001); NAPI alertness scores and days in NICU (r = −0.16; p = 0.037); and NAPI irritability scores and gestational age (r = 0.21; p = 0.006). There were no significant associations with other markers of adverse outcome. Only NAPI irritability scores were correlated with MDI scores (r = −0.16; p = 0.040) but accounted for little additional variance after adjustment for neonatal factors (ΔR 2 = 0.035; p = 0.012). Conclusion: We found little evidence of the utility of the NAPI as a measure of short‐term neurobehavioural function or for predicting neurodevelopmental outcomes in very preterm infants. It may have greater predictive power when used serially to detect delayed neurobehavioural maturation.