Abstract:
CONTEXT:Developmental outcomes of very preterm (gestational age ≤32 weeks) or very low birth weight (<1500 g) children are commonly reported before age 3 years although the predictive validity for later outcomes are uncertain. OBJECTIVE:To determine the validity of early developmental assessments in predicting school-age cognitive deficits. DATA SOURCES:PubMed. STUDY SELECTION:English-language studies reporting at least 2 serial developmental/cognitive assessments on the same population, 1 between ages 1 and 3 years and 1 at ≥5 years. DATA EXTRACTION:For each study, we calculated the sensitivity, specificity, and positive and negative predictive values of early assessment for cognitive deficit (defined as test scores 1 SD below the population mean). Pooled meta-analytic sensitivity and specificity were estimated by using a hierarchical summary receiver operator characteristic curve. RESULTS:We included 24 studies (n = 3133 children). Early assessments were conducted at 18 to 40 months and generally involved the Bayley Scales of Infant Development or the Griffiths Mental Development Scales; 11 different cognitive tests were used at school-age assessments at 5 to 18 years. Positive predictive values ranged from 20.0% to 88.9%, and negative predictive vales ranged from 47.8% to 95.5%. The pooled sensitivity (95% confidence interval) of early assessment for identifying school-age cognitive deficit was 55.0% (45.7%-63.9%) and specificity was 84.1% (77.5%-89.1%). Gestational age, birth weight, age at assessment, and time between assessments did not explain between-study heterogeneity. LIMITATIONS:The accuracy of aggregated data could not be verified. Many assessment tools have been superseded by newer editions. CONCLUSIONS:Early developmental assessment has poor sensitivity but good specificity and negative predictive value for school-age cognitive deficit.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Wong HS,Santhakumaran S,Cowan FM,Modi N,Medicines for Neonates Investigator Group.doi
10.1542/peds.2016-0251subject
Has Abstractpub_date
2016-08-01 00:00:00issue
2eissn
0031-4005issn
1098-4275pii
peds.2016-0251journal_volume
138pub_type
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