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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Are outcomes of extremely preterm infants improving? Impact of Bayley assessment on outcomes

Betty R Vohr1, Bonnie E Stephens, Rosemary D Higgins

  • 1Department of Pediatrics, Women & Infants' Hospital, Brown University, Providence, RI 02905, USA. bvohr@wihri.org

The Journal of Pediatrics
|March 17, 2012
PubMed

Insights

The Bayley III scale showed higher cognitive scores and a 70% reduction in neurodevelopmental impairment (NDI) rates for extremely low birth weight infants compared to the Bayley II. Caution is advised when interpreting Bayley scores.

Area of Science:

  • Neonatal research
  • Neurodevelopmental assessment
  • Pediatric developmental outcomes

Background:

  • Extremely low birth weight (ELBW) infants face significant risks for neurodevelopmental impairment (NDI).
  • Accurate assessment tools are crucial for identifying developmental delays and guiding interventions in this vulnerable population.
  • The evolution of assessment tools, such as the Bayley Scales of Infant Development, necessitates comparative studies to understand changes in outcome measures.

Purpose of the Study:

  • To compare cognitive scores and NDI rates in ELBW infants using two versions of the Bayley Scales: Bayley II (2006-2007) and Bayley III (2008-2011).
  • To evaluate the impact of using different assessment tools on the identification of neurodevelopmental impairment.

Main Methods:

  • A comparative study analyzing cognitive scores and NDI rates in ELBW infants across two distinct time periods.
  • Utilized bivariate and regression analyses to compare outcomes between infants assessed with Bayley II and Bayley III.
  • Defined NDI using multiple criteria based on cognitive, language, and motor scores from the Bayley III.

Main Results:

  • Mean cognitive scores were 11 points higher with the Bayley III compared to the Bayley II.
  • The overall NDI rate decreased significantly from 43% (Bayley II) to 13% (Bayley III), a 70% reduction (P < .0001).
  • Multivariate analyses indicated that the Bayley III was associated with a decreased risk of NDI across various definitions (P < .001).

Conclusions:

  • The Bayley III may overestimate cognitive performance or represent a more sensitive measure of emerging cognitive skills compared to the Bayley II.
  • The significant reduction in identified disability rates highlights the need for cautious interpretation of Bayley III scores.
  • It is recommended that all ELBW infants receive early intervention services upon NICU discharge, irrespective of initial Bayley scores.
Abstract

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