Rates of developmental delays are still high among premature babies despite increased survival rates over the past 20 years, according to findings recently published in BMJ.
“The Ages and Stages Questionnaire is the most commonly used parent-completed developmental screening test worldwide and is accepted by the American Academy of Pediatrics as a valid developmental screening tool,” Véronique Pierrat, neonatologist and researcher, obstetrical, perinatal and pediatric epidemiology team, Paris Descartes University, and colleagues wrote. “It could thus be useful for both large cohort studies and routine follow-up as a first step approach to increase early detection of neurodevelopmental delay. However, its use in a national population of preterm children has never been evaluated.”
To assess the tool, researchers compared rates of survival and neurodevelopmental outcomes among children born alive in France at 22 to 26 weeks, 27 to 31 weeks, and 32 to 34 weeks in 2011 with those of neonates born 1997.
Pierrat and colleagues found that among 5,170 live births, survival at 2 years corrected age was 51.7% at 22 to 26 weeks’ gestation; 93.1% at 27 to 31 weeks’ gestation; and 98.6% at 32 to 34 weeks’ gestation. Of the 3,599 infants where data on cerebral palsy were available, the overall rate of that disorder was at 6.9% at 24 to 26 weeks’ gestation; 4.3% at 27 to 31 weeks’ gestation; and 1% at 32 to 34 weeks’ gestation.
In addition, researchers reported that of 2,506 answers to The Ages and Stages Questionnaire, the proportion of children with results of at least one of that questionnaire’s five domains below threshold at 24 to 26 weeks’ gestation were 50.2%; 40.7% at 27 to 31 weeks’ gestation; and 36.2% at 32 to 34 weeks’ pregnancy. The only significant change in survival without severe or moderate neuromotor or sensory disabilities between 1997 and 2011 was among those born at 25 to 26 weeks gestation; the rate went from 45.5% to 62.3%.
The authors suggested an alternative to what they called the “costly” and “time consuming” Bayley Scales of Infant Development that is currently frequently used ascertain a young child’s development.
“Parental questionnaires are increasingly popular to assess development, as they are easy to administer and interpret, have a short completion time, and can decrease medical expenditure,” Pierrat and colleagues wrote. “In addition, they may be used in the community, have the capacity to facilitate parental involvement, and enable clinicians to focus on those children suspected of having developmental delay and hence needing further developmental assessment.” – by Janel Miller
Disclosures: Healio Family Medicine was unable to determine researchers' relevant financial disclosures prior to publication.