Early human development · 2017
The ability of early serial developmental assessment to predict outcome at 5years following neonatal hypoxic-ischaemic encephalopathy.
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O'Connor Catherine M, Ryan C Anthony, Boylan Geraldine B, Murray Deirdre M
Аннотация
BACKGROUND: Neurodevelopmental difficulties in children following hypoxic-ischaemic encephalopathy (HIE) may not emerge until school age.
AIMS: To evaluate the value and stability of early serial developmental assessments in predicting long-term outcome.
STUDY DESIGN: Prospective study of infants with neonatal HIE and early continuous EEG at birth.
SUBJECTS: Term infants with HIE were recruited at birth. Development was measured at 6, 12 and 24months using the Revised Griffiths' Scales (GMDS-R).
OUTCOME MEASURES: Intellectual abilities at age five were measured using the Wechsler Preschool & Primary Scale of Intelligence (WPPSI-IIIUK) and the 'numbers' subtest from the Children's Memory Scale. Overall five-year outcome was also reported.
RESULTS: IQ outcome was available in forty-seven surviving children (28 male, 19 female: mean (SD) age 64.0(5.7) months. Mean processing speed (p=0.01) and short-term verbal memory (p=0.005) were below the norm. Global development (GDQ) at 6, 12 and 24months correlated (p<0.01) with five-year global, verbal and performance IQ with improved correlation over time. Normal GDQ throughout early childhood predicted normal IQ at 5years (24month AUROC value=0.941, p=0.001). An abnormal early GDQ score at any stage in the first 24months had excellent negative predictive values, superior to those for neonatal Sarnat and EEG grading.
CONCLUSIONS: Normal early development predicts normal 5year IQ with prediction increasing over time. Repeated measurement is warranted due to instability of findings across the first two years. Follow-up for children with abnormal early development is warranted given high sensitivity for school-age global abnormal outcome.
AIMS: To evaluate the value and stability of early serial developmental assessments in predicting long-term outcome.
STUDY DESIGN: Prospective study of infants with neonatal HIE and early continuous EEG at birth.
SUBJECTS: Term infants with HIE were recruited at birth. Development was measured at 6, 12 and 24months using the Revised Griffiths' Scales (GMDS-R).
OUTCOME MEASURES: Intellectual abilities at age five were measured using the Wechsler Preschool & Primary Scale of Intelligence (WPPSI-IIIUK) and the 'numbers' subtest from the Children's Memory Scale. Overall five-year outcome was also reported.
RESULTS: IQ outcome was available in forty-seven surviving children (28 male, 19 female: mean (SD) age 64.0(5.7) months. Mean processing speed (p=0.01) and short-term verbal memory (p=0.005) were below the norm. Global development (GDQ) at 6, 12 and 24months correlated (p<0.01) with five-year global, verbal and performance IQ with improved correlation over time. Normal GDQ throughout early childhood predicted normal IQ at 5years (24month AUROC value=0.941, p=0.001). An abnormal early GDQ score at any stage in the first 24months had excellent negative predictive values, superior to those for neonatal Sarnat and EEG grading.
CONCLUSIONS: Normal early development predicts normal 5year IQ with prediction increasing over time. Repeated measurement is warranted due to instability of findings across the first two years. Follow-up for children with abnormal early development is warranted given high sensitivity for school-age global abnormal outcome.