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Comparative analysis of developmental outcomes in very preterm infants: BSID-II versus Bayley-III German norms
Marlene Hammerl1, Martina Zimmermann1, Anna Posod1
1Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria.
Insights
The Bayley-III scales, using German norms, identified more children needing intervention at 24 months compared to the BSID-II. This supports clinical use and scientific comparison for very preterm infants.
Area of Science:
- Pediatric developmental assessment
- Neonatal neurodevelopmental outcomes
- Comparative psychometrics
Background:
- Bayley Scales of Infant and Toddler Development, third edition (Bayley-III) US norms showed outcome overestimation.
- Conformity between BSID-II and Bayley-III German norms in preterm infants is unknown.
Purpose of the Study:
- To compare outcomes of very preterm infants assessed with BSID-II and Bayley-III using German norms.
- Evaluate the clinical utility and comparability of Bayley-III German norms against BSID-II.
Main Methods:
- Retrospective analysis of 649 very preterm infants assessed at 12 and/or 24 months.
- Comparison of BSID-II Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) with Bayley-III cognitive and motor composite scores.
- Definition of abnormal outcomes as scores <85 (delay) or <70 (impairment).
Main Results:
- At 12 months, Bayley-III cohort showed higher scores across all domains and lower motor delay rates than BSID-II.
- At 24 months, Bayley-III motor scores were higher, but cognitive impairment rates were elevated.
- Significant differences observed in motor and cognitive outcomes between the two scales.
Conclusions:
- Bayley-III German norms effectively identify children requiring interventions, especially at 24 months corrected age.
- Findings support the clinical application and scientific comparability of Bayley-III with BSID-II in German preterm populations.
- The scale differences highlight the importance of norm selection in developmental assessments.
Introduction:
After the release of the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), US norms, an overestimation of outcome was observed. But, the conformity between the Bayley Scales of Infant Development, second edition (BSID-II), and the Bayley-III German norms is unknown. This retrospective analysis aimed to compare outcomes of very preterm infants tested with BSID-II and Bayley-III German norms.
Methods:
Infants born from November 2007 to July 2018 were included. Exclusion criteria were death or missing outcome. Infants underwent testing with either BSID-II until December 2013 or Bayley-III from January 2014 onward, at 12 and/or 24 months. BSID-II Mental Developmental Index (MDI) was compared to Bayley-III cognitive score and a combined Bayley-Score (CB-III) consisting of the cognitive and language composite score. BSID-II Psychomotor Developmental Index (PDI) was compared to Bayley-III motor composite score. Abnormal outcomes were defined as scores <85 (delay) or <70 (impairment).
Results:
649 infants were included. At 12 months, the Bayley-III cohort achieved higher scores in all domains compared to the BSID-II cohort (all p<0.05), with lower rates of motor delay in the Bayley-III cohort (p<0.001). At 24 months, only Bayley-III motor composite scores were higher than the BSID-II PDI (p<0.001). Rates of cognitive impairment were higher in the Bayley-III cohort (p = 0.013).
Interpretation:
Our findings indicate that the Bayley-III German norms effectively identify children needing interventions, particularly at 24 months corrected age. This supports both clinical application and scientific comparability with the BSID-II.
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