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新生儿重症监护病房(NICU)随访门诊中发育评估的预测价值。

Predictive Value of Developmental Assessment in a Neonatal Intensive Care Unit (NICU) Follow-Up Clinic.

机构信息

Department of Pediatrics, University of Minnesota Medical School.

出版信息

J Pediatr Psychol. 2021 Aug 11;46(7):814-823. doi: 10.1093/jpepsy/jsab048.

DOI:10.1093/jpepsy/jsab048
PMID:34142154
Abstract

OBJECTIVE

Neonatal Intensive Care Unit (NICU) Follow-Up programs vary in the duration for which they monitor child development and neurocognitive outcomes. This study explores the early predictive value of a widely used developmental measure for intellectual functioning during early childhood to better inform whether there is value added in continued monitoring.

METHODS

Participants were 209 children who had at least two assessments between the ages of 1 and 6 years old as part of NICU Follow-Up clinic. The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) was administered when children were 1 and 2 years old and the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) was administered when children were 3 years and older.

RESULTS

The Bayley-III at 1 year of age was a significant predictor of Bayley-III performance at age 2. Similarly, Bayley-III at ages 1 year and 2 years were significant predictors of WPPSI-IV performance. Strength of prediction was moderate with the majority of variance unexplained. Exploratory analyses examining whether early developmental abilities as assessed on the Bayley-III could identify patients at risk for poorer WPPSI-IV performance indicated appropriate specificity but inadequate sensitivity.

CONCLUSIONS

This study supports ongoing assessment of children who were born with perinatal complications into at least early childhood. Assessing development only during the infant and toddler years did not sufficiently identify children who went on to have lower cognitive functioning in preschool and the early school years.

摘要

目的

新生儿重症监护病房(NICU)随访计划在监测儿童发育和神经认知结果的时间长短上存在差异。本研究探讨了一种广泛使用的发育评估方法在幼儿期智力功能方面的早期预测价值,以更好地了解持续监测是否具有附加价值。

方法

参与者为 209 名儿童,他们在 NICU 随访诊所至少进行了两次 1 至 6 岁之间的评估。当儿童 1 岁和 2 岁时进行贝利婴幼儿发育量表第三版(Bayley-III)评估,当儿童 3 岁及以上时进行韦氏学前和小学智力量表第四版(WPPSI-IV)评估。

结果

1 岁时的 Bayley-III 是 2 岁时 Bayley-III 表现的显著预测因素。同样,1 岁和 2 岁时的 Bayley-III 也是 WPPSI-IV 表现的显著预测因素。预测强度为中度,大部分方差无法解释。对早期发育能力(如 Bayley-III 评估)是否可以识别存在 WPPSI-IV 表现较差风险的患者进行的探索性分析表明,其具有适当的特异性但敏感性不足。

结论

本研究支持对有围产期并发症的儿童进行持续评估,至少要持续到幼儿期。仅在婴儿和幼儿期评估发育情况并不能充分识别在学龄前和小学早期认知功能较低的儿童。

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