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Qiu H, Zhang H, Zhang J, Kuo F, Huysentruyt K, Smith C, Bhutada AM, Xiao N, Xu K. International consensus on early rehabilitation and nutritional management for infants at high risk of neurological impairments. Pediatr Investig 2024; 8:159-170. [PMID: 39347521 PMCID: PMC11427905 DOI: 10.1002/ped4.12426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/16/2024] [Indexed: 10/01/2024] Open
Affiliation(s)
- Huiying Qiu
- Department of RehabilitationGuangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangdongChina
| | - Huayan Zhang
- Division of NeonatologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- Department of NeonatologyGuangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangdongChina
| | - Jingbo Zhang
- Department of RehabilitationGuangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangdongChina
| | - Fengyi Kuo
- Semel Institute for Neuroscience and Human BehaviorUniversity of CaliforniaLos AngelesCaliforniaUSA
- Department of RehabilitationLIH HealthcareBeijingChina
| | - Koen Huysentruyt
- Brussels Centre for Intestinal Rehabilitation in ChildrenVrije Universiteit BrusselBrusselsBelgium
| | - Christopher Smith
- Department of Nutrition and DieteticsRoyal Alexandra Children's HospitalBrightonUK
| | - Ankita M. Bhutada
- Asante Three Rivers Medical Centre (Inpatient & Outpatient), Asante Health SystemOregonUSA
- Department of Speech Pathology and AudiologyUniversity of South AlabamaMobileAlabamaUSA
| | - Nong Xiao
- Department of RehabilitationChongqing Medical University Affiliated Children's HospitalChongqingChina
| | - Kaishou Xu
- Department of RehabilitationGuangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangdongChina
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Neel ML, Conroy S, Srinivas R, Taylor HG, Stark AR, de Silva A, Busch T, Maitre NL. Bayley trajectories predict school readiness better than single assessments in formerly very preterm preschoolers. Pediatr Res 2023; 94:1392-1399. [PMID: 37217606 DOI: 10.1038/s41390-023-02656-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 01/19/2023] [Accepted: 02/22/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Development of children born very preterm (VPT) is evaluated using the Bayley Scales of Infant Development. Early Bayley scores may not predict later outcomes. We studied whether VPT Bayley trajectories in the early years predicted school readiness better than single assessments. METHODS We prospectively evaluated 53 VPT at 4-5 years using standardized measures of school readiness, including the domains of cognition, early mathematical and literacy abilities, and motor skills. Predictors were Bayley-III scores obtained 1-5 times/child between 6 and 35 months. Linear mixed models (LMM) with random effects extracted estimated random effect for slope (change in Bayley score/1 year) and fixed+random effect sum for the intercept (initial Bayley score) for each participant, to then evaluate 4-5-year outcomes prediction. RESULTS Variability of individual trajectories prevailed across developmental domains. For the initial LMM, adding Bayley change to models with only initial score improved model fits for several Bayley-III domains. Models containing estimates for initial Bayley scores and Bayley change explained significantly more variability in school readiness scores (21-63%) than either variable alone. CONCLUSION Neurodevelopmental follow-up of VPT is more relevant to school readiness when children are assessed multiple times in the first 3 years. Neonatal intervention research could use early trajectories rather than single timepoints as outcomes. IMPACT This study is the first to examine individual Bayley scores and trajectories to predict school readiness of formerly preterm children at 4-5 years. Modeling demonstrated extreme variability of individual trajectories compared to the group's average trajectories. Models containing initial Bayley scores and Bayley change over time explained more variability in preschool readiness than either variable alone. Using the Bayley to predict future school readiness is enhanced by administration across multiple follow-up visits and inclusion of change across the first 3 years. Follow-up care models and clinical trial design for neonatal interventions may benefit from a trajectory-based approach to outcomes evaluation.
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Affiliation(s)
- Mary Lauren Neel
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA.
| | - Sara Conroy
- Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Biostatistics Resource at Nationwide Children's Hospital, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Rachelle Srinivas
- Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Hudson Gerry Taylor
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Ann R Stark
- Department of Neonatology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, USA
| | - Aryanne de Silva
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Tyler Busch
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Nathalie L Maitre
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA
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