Kim Chae Young, Jung Euiseok, Lee Byong Sop, Kim Ki-Soo, Kim Ellen Ai-Rhan
Division of Neonatology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Pediatr. 2019 May;62(5):187-192. doi: 10.3345/kjp.2018.07381. Epub 2019 Mar 20.
The importance of the neurodevelopmental outcomes of very-low-birth-weight (VLBW) infants has been emphasized as their mortality rate has markedly improved. This study aimed to assess the validity of the Korean Developmental Screening Test (K-DST), a developmental screening tool approved by the Korean Society of Pediatrics, for the timely diagnosis of neurodevelopmental delay in VLBW infants.
Subjects included VLBW infants enrolled in the Korean Neonatal Network database between January 2012 and December 2014. The collected data were analyzed for sensitivity, specificity, positive predictive value, and negative predictive value (NPV) in the K-DST compared to those in the Bayley Scales of Infant Development-II for VLBW infants.
A total of 173 patients were enrolled. Their mean gestational age and mean birth weight were 27.5±2.8 weeks and 980.5±272.1 g, respectively. The frequency of failed psychomotor developmental index (PDI) <85 was similar to that in at least one domain of K-DST <1 standard deviation. Failure in more than one K-DST domain compared with a mental developmental index (MDI) <85 showed a sensitivity and NPV of 73.2% and 75.0%, respectively. Failure in more than one K-DST domain compared with PDI <85 showed a sensitivity and NPV of 60.3% and 71.6%, respectively. Each K-DST domain had a stronger correlation with predicting a failing MDI <85 than a failing PDI <85 (P<0.05).
K-DST could be a useful screening tool for predicting mental developmental delay in VLBW infants and referring them for neurodevelopmental assessments.
随着极低出生体重(VLBW)婴儿死亡率显著改善,其神经发育结局的重要性已得到强调。本研究旨在评估韩国儿科学会批准的发育筛查工具——韩国发育筛查测试(K-DST)对VLBW婴儿神经发育延迟进行及时诊断的有效性。
研究对象包括2012年1月至2014年12月期间纳入韩国新生儿网络数据库的VLBW婴儿。将收集到的数据与VLBW婴儿的贝利婴儿发育量表第二版(Bayley Scales of Infant Development-II)相比,分析K-DST的敏感性、特异性、阳性预测值和阴性预测值(NPV)。
共纳入173例患者。他们的平均胎龄和平均出生体重分别为27.5±2.8周和980.5±272.1克。精神运动发育指数(PDI)<85的频率与K-DST至少一个领域<1个标准差的频率相似。与精神发育指数(MDI)<85相比,K-DST多个领域未通过的敏感性和NPV分别为73.2%和75.0%。与PDI<85相比,K-DST多个领域未通过的敏感性和NPV分别为60.3%和71.6%。与预测PDI<85未通过相比,K-DST的每个领域与预测MDI<85未通过的相关性更强(P<0.05)。
K-DST可能是预测VLBW婴儿精神发育延迟并将其转诊进行神经发育评估的有用筛查工具。