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18-22 月龄校正年龄时的贝利 III 综合评分是否能预测极早产儿 6-7 岁时的全量表智商?

Do Bayley-III Composite Scores at 18-22 Months Corrected Age Predict Full-Scale IQ at 6-7 Years in Children Born Extremely Preterm?

机构信息

Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM.

Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC.

出版信息

J Pediatr. 2023 Dec;263:113700. doi: 10.1016/j.jpeds.2023.113700. Epub 2023 Aug 26.

Abstract

OBJECTIVE

To determine the ability of the Bayley-III cognitive and language composite scores at 18-22 months corrected age to predict WISC-IV Full Scale IQ (FSIQ) at 6-7 years in infants born extremely preterm.

STUDY DESIGN

Children in this study were part of the Neuroimaging and Neurodevelopmental Outcome cohort, a secondary study to the SUPPORT trial and born 24-27 weeks gestational age. Bayley-III cognitive and language scores and WISC-IV FSIQ were compared with pairwise Pearson correlation coefficients and adjusted for medical and socioeconomic variables using linear mixed effect regression models.

RESULTS

Bayley-III cognitive (r = 0.33) and language scores (r = 0.44) were mildly correlated with WISC-IV FSIQ score. Of the children with Bayley-III cognitive scores of <70, 67% also had FSIQ of <70. There was less consistency for children with Bayley-III scores in the 85-100 range; 43% had an FSIQ of <85 and 10% an FSIQ of <70. Among those with Bayley-III language scores >100, approximately 1 in 5 had an FSIQ of <85. A cut point of 92 for the cognitive composite score resulted in sensitivity (0.60), specificity (0.64). A cut point of 88 for the language composite score produced sensitivity (0.61), specificity (0.70).

CONCLUSIONS

Findings indicate the Bayley-III cognitive and language scores correlate with later IQ, but may fail to predict delay or misclassify children who are not delayed at school age. The Bayley-III can be a useful tool to help identify children born extremely preterm who have below average cognitive scores and may be at the greatest risk for ongoing cognitive difficulties.

TRIAL REGISTRATION

Extended Follow-up at School Age for the SUPPORT Neuroimaging and Neurodevelopmental Outcomes (NEURO) Cohort: NCT00233324.

摘要

目的

确定贝利婴幼儿发展量表第三版(Bayley-III)认知和语言综合评分在矫正月龄 18-22 个月时预测婴儿极低出生体重儿在 6-7 岁时韦氏智力测验第四版(WISC-IV)全量表智商(FSIQ)的能力。

研究设计

本研究中的儿童是支持试验的神经影像学和神经发育结局的二级研究中的一部分,出生胎龄 24-27 周。通过配对 Pearson 相关系数比较 Bayley-III 认知和语言评分与 WISC-IV FSIQ,并用线性混合效应回归模型调整医疗和社会经济变量。

结果

Bayley-III 认知评分(r=0.33)和语言评分(r=0.44)与 WISC-IV FSIQ 评分呈轻度相关。在 Bayley-III 认知评分<70 的儿童中,67%的儿童 FSIQ 也<70。对于 Bayley-III 评分在 85-100 范围内的儿童,一致性较差;43%的儿童 FSIQ<85,10%的儿童 FSIQ<70。在 Bayley-III 语言评分>100 的儿童中,大约有 1/5 的儿童 FSIQ<85。认知综合评分的 92 分切点产生了敏感性(0.60),特异性(0.64)。语言综合评分 88 分切点产生敏感性(0.61),特异性(0.70)。

结论

研究结果表明,Bayley-III 认知和语言评分与后期智商相关,但可能无法预测学龄期延迟或错误分类无延迟的儿童。Bayley-III 可以作为一种有用的工具,帮助识别认知评分低于平均水平且可能存在持续认知困难风险最大的极低出生体重儿。

试验注册

支持神经影像学和神经发育结局(NEURO)队列的学龄期扩展随访:NCT00233324。

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