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The predictive value of 'red flags' as milestones of psychomotor development of premature babies - preliminary study
Jolanta Taczała1, Michał Latalski2, Anna Aftyka3
1Department of Rehabilitation, Physiotherapy and Balneotherapy, Faculty of Health Sciences, Medical University, Lublin, Poland.
Insights
Developmental red flags at 9 months can predict risks for cerebral palsy (CP) and autism spectrum disorders (ASD) in premature infants. These early indicators aid in timely intervention for at-risk babies.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Neurodevelopmental disorders
Background:
- Extremely premature infants face heightened risks of persistent brain damage, including cerebral palsy (CP), autism spectrum disorders (ASD), and intellectual disability.
- Early identification of developmental risks is crucial for timely intervention and improved outcomes in this vulnerable population.
- Long-term psychomotor development monitoring by interdisciplinary teams is essential for at-risk premature infants.
Purpose of the Study:
- To evaluate the prognostic value of developmental "red flags" in identifying early risks of CP and ASD in extremely premature infants.
- To assess the ability of "red flags" at 9 months corrected age to predict later developmental outcomes.
- To demonstrate the utility of these markers in clinical practice for at-risk neonates.
Main Methods:
- A preliminary study involving 42 infants born before 32 weeks of gestation.
- Assessment of developmental milestones and "red flags" at 9 months corrected age.
- Correlation of 9-month "red flags" with developmental status at 24 months corrected age.
Main Results:
- The presence of "red flags" in gross motor, fine motor, and cognitive domains at 9 months strongly predicted their presence at 24 months.
- High sensitivity and specificity were observed for gross motor (0.91, 0.94), fine motor (0.83, 1.00), and cognitive (1.00, 0.97) domains.
- While other developmental spheres showed lower sensitivity, they exhibited high specificity for predicting outcomes.
Conclusions:
- Developmental "red flags" identified at 9 months can reliably predict normal development, developmental delay, and the risk of CP and ASD in premature infants.
- These "red flags" are readily available and do not require specialized, costly training for use.
- Their implementation in routine medical practice is recommended for early risk detection in premature infants.
Introduction:
Premature babies are a special group at risk of persistent brain damage caused by diseases, the most serious of which are cerebral palsy(CP), autism spectrum disorders (ASD) and mental retardation, among others. These conditions may occur concurrently, but appear more often as separate disease syndromes in the same group of at-risk children. Long-term observation of psychomotor development by an interdisciplinary medical team closely cooperating with parents is necessary. It is important to detect the risk of developing these diseases as soon as possible in all development spheres.
Material And Methods:
The research was conducted to demonstrate the prognostic value of 'red flags' of developmental milestones and the ability to detect early signs of risk of developing CP and ASD in extremely premature babies. In this preliminary study, 42 preterm babies, born after less than 32 weeks pregnancy participated.
Results:
The occurrence of 'red flags'in the spheres: gross motor, fine motor and cognitive at 9 months was strongly associated with their presence at 24 months. The sensitivity and specificity were: gross motor - 0.91 (95% CI: 0.59, 1.00) and 0.94 (95% CI: 0.79, 0.99); fine motor - 0.83 (95% CI 0.36-1.00) and 1.00 (95% CI: 0.90-1.00); cognitive - 1.00 (0.40, 1.00) and 0.97 (0.86, 1.00). Other spheres had lower sensitivity but high specificity.
Conclusions:
The conclusion is that the 'red flags'at the 9 months milestones already predict the normal or developmental delay of premature babies, and predict the risk of CP and ASD. Due to the availability and lack of the need for specialized and costly training, it is worth considering their use in everyday life medical practice.
