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High threshold of total developmental quotient at 3 years for follow-up in extremely preterm infants
Takashi Maeda1, Yoshihiro Tanahashi2, Hideyuki Asada3
1Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
Insights
Developmental quotient (DQ) at age 3 predicts school support needs in extremely preterm infants. Higher DQ scores correlate with lower educational support requirements, especially when detailed subscales are considered.
Area of Science:
- Neonatal Development
- Developmental Pediatrics
- Educational Psychology
Background:
- Extremely preterm infants (<28 weeks gestation) face neurodevelopmental challenges.
- Early identification of developmental trajectories is crucial for timely interventions.
- Predicting the need for educational support aids in resource allocation and tailored learning plans.
Purpose of the Study:
- To examine the association between developmental quotient (DQ) at 3 years and the need for educational support in school-aged extremely preterm infants.
- To determine if refined DQ stratification improves prediction accuracy for educational support.
Main Methods:
- Analysis of 176 extremely preterm infants (<28 weeks gestation).
- Neurodevelopmental assessment at age 3 using the Kyoto Scale of Psychological Development (KSPD) for total DQ and subscales.
- Stratification of DQ into conventional (delay, subnormal, normal) and modified (low-normal, high-normal) categories.
- Comparison of educational support prevalence across DQ strata and analysis of subscale differences.
Main Results:
- In conventional DQ stratification, educational support was needed by 63% with developmental delay, 24% subnormal, and 15% normal.
- Modified stratification showed 26% for low-normal DQ and 5% for high-normal DQ.
- Low-normal DQ (85-<93) significantly increased odds of educational support (OR 6.00) compared to high-normal DQ (≥93).
- The language-social subscale was lower in low-normal DQ infants requiring educational support.
Conclusions:
- Higher developmental quotient (DQ) thresholds and detailed subscale evaluation at age 3 are valuable for predicting educational support needs in extremely preterm infants.
- This approach aids in more precise developmental follow-up and intervention planning.
- Refined neurodevelopmental assessment can optimize educational support for high-risk infant populations.
Aim:
To investigate the relationship between the developmental quotient (DQ) at age 3 years and the need for educational support at school age in extremely preterm infants.
Methods:
A total of 176 infants with a gestational age of <28 weeks were analyzed. The total DQ and subscales were evaluated using the Kyoto Scale of Psychological Development (KSPD) test. Neurodevelopment at age 3 years was stratified using total DQ in a conventional (DQ < 70 as developmental delay, DQ 70- <85 as subnormal, DQ ≥85 as normal) and a modified way (subdividing normal into DQ 85- <93 as low-normal and DQ ≥93 as high-normal). The prevalence of future educational support was compared for each stratum. Additionally, subscales were compared between those with and without educational support in each total DQ stratum.
Results:
In conventional stratification, the prevalence of educational support was 32 (63 %) for developmental delay, 14 (24 %) for subnormal, and 10 (15 %) for normal. In modified stratification, the prevalence was 8 (26 %) for low-normal and 2 (5 %) for high-normal. While there was no significant difference in the odds of educational support between the normal and subnormal, the low-normal had significantly higher odds compared to the high-normal (OR 6.00; 95 % CI, 1.16-30.95, p = 0.03). Among the low-normal stratum, the language-social subscale was significantly lower in those with educational support.
Conclusion:
Setting high thresholds for total DQ and evaluating detailed subscales at age 3 years may be useful for developmental follow-up in extremely preterm infants.
