Title
Development and evaluation of a follow up assessment of preterm infants at 5 years of age
Author
de Kleine, M.J.K.
den Ouden, A.L.
Kollée, L.A.A.
van der Nijhuis - Sanden, M.W.G.
Sondaar, M.
Kessel van - Feddema, B.J.M.
Knuijt, S.
van Baar, A.L.
Ilsen, A.
Breur-Pieterse, R.
Briët, J.M.
Brand, R.
Verloove-Vanhorick, S.P.
Publication year
2003
Abstract
Background: Long term follow up shows a high frequency of developmental disturbances in preterm survivors of neonatal intensive care formerly considered non-disabled. Aims: To develop and validate an assessment tool that can help paediatricians to identify before 6 years of age which survivors have developmental disturbances that may interfere with normal education and normal life. Methods: A total of 431 very premature infants, mean gestational age 30.2 weeks, mean birth weight 1276 g, were studied at age 5 years. Children with severe handicaps were excluded. The percentage of children with a correctly identified developmental disturbance in the domains cognition, speech and language development, neuromotor development, and behaviour were determined. Results: The follow up instrument classified 67% as optimal and 33% as at risk or abnormal. Of the children classified as at risk or abnormal, 60% had not been identified at earlier follow up assessments. The combined set of standardised tests identified a further 30% with mild motor, cognitive, or behavioural disturbances. The paediatrician's assessment had a specificity of 88% (95% CI 83-93%), a sensitivity of 48% (95% CI 42-58%), a positive predictive value of 85% (95% CI 78-91%), and a negative predictive value of 55% (95% CI 49-61%). Conclusions: Even after standardised and thorough assessment, paediatricians may overlook impairments for cognitive, motor, and behavioural development. Long term follow up studies that do not include detailed standardised tests for multiple domains, especially fine motor domain, may underestimate developmental problems.
Subject
Health
Birth weight
Child
Cognitive defect
Cognitive development
Controlled study
Developmental coordination disorder
Developmental disorder
Diagnostic accuracy
Disease classification
Disease severity
Evaluation
Female
Follow up
Gestational age
Language development
Major clinical study
Male
Medical assessment
Newborn intensive care
Pediatrician
Prematurity
Psychomotor development
Risk assessment
Speech development
Survival time
Child, Preschool
Developmental Disabilities
Follow-Up Studies
Health Status Indicators
Humans
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Predictive Value of Tests
Prognosis
Psychometrics
Questionnaires
Reproducibility of Results
Risk Factors
Sensitivity and Specificity
To reference this document use:
http://resolver.tudelft.nl/uuid:9aa59494-687f-4823-a0af-dd2c47ae9dd0
DOI
https://doi.org/10.1136/adc.88.10.870
TNO identifier
237289
ISSN
0003-9888
Source
Archives of Disease in Childhood, 88 (10), 870-875
Document type
article