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Neuroimaging and neurodevelopmental outcome after early fetal growth restriction: NEUROPROJECT-FGR. Pediatr Res 2021; 90:869-875. [PMID: 33469173 DOI: 10.1038/s41390-020-01333-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 11/24/2020] [Accepted: 12/09/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Adverse neurodevelopmental outcomes and MRI alterations are reported in infants born after fetal growth restriction (FGR). This study evaluates the additional role of FGR over prematurity in determining brain impairment. METHODS Retrospective observational study comparing 48 FGR and 36 appropriate for gestational age infants born between 26 and 32 weeks' gestation who underwent a cerebral MRI at term equivalent age. Exclusion criteria were twins, congenital anomalies, and findings of overt brain lesions. Main outcomes were total maturation score (TMS) and cerebral areas independently measured by two neuro-radiologists and Griffiths or Bayley scale III scores at median age of 2 years. RESULTS TMS was not significantly different between the groups. Inner calvarium and parenchyma's areas were significantly smaller in FGR cases. There were no significant differences in the average quotient scores. A positive correlation between parenchyma area and cognitive score was found (r = 0.372, p = 0.0078) and confirmed after adjusting for sex, gestational age, and birth weight (p = 0.0014). Among FGR, the subgroup with umbilical arterial Doppler velocimetry alterations had significantly worse gross motor scores (p = 0.005). CONCLUSIONS FGR plays additional role over prematurity in determining brain impairment. An early structural dimensional MRI evaluation may identify infants who are at higher risk. IMPACT Fetal growth-restricted infants showed smaller cerebral parenchymal areas than preterm controls. There is a positive correlation between the parenchyma area and the cognitive score. These results highlight the already known link between structure and function and add importance to the role of a structural dimensional MRI evaluation even in the absence of overt brain lesions.
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Ferreira-Vasques AT, Lamônica DAC. Avaliação instrumentalizada do desenvolvimento infantil: nova realidade brasileira. Codas 2018; 30:e20180056. [DOI: 10.1590/2317-1782/20182018056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/28/2018] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Apresentar a Escala de Desenvolvimento Mental de Griffiths (EDMG), bem como sua adaptação transcultural para o Brasil. Método EDMG é um instrumento diagnóstico de avaliação do desenvolvimento infantil. O resultado de sua aplicação permite verificar se o desenvolvimento é típico ou se há diagnóstico de alteração em determinada área específica (motora grossa, pessoal-social, linguagem, motora fina-adaptativa e execução) ou do desenvolvimento global. Após contato com autores, permissão de utilização da EDMG e cumprimento dos aspectos éticos, a versão do instrumento em português europeu foi adaptada para o português brasileiro, com manutenção de equivalências semântica, idiomática, experimental e conceitual. A adaptação foi realizada por duas fonoaudiólogas, experientes em avaliação de lactentes, que realizaram o curso de capacitação para aplicar o instrumento. A versão final adaptada foi aplicada em 21 lactentes com desenvolvimento típico. Resultados Foram adaptados 39 itens, sem exclusão alguma. Todos os itens foram possíveis de serem aplicados, adequados à faixa etária alvo, sem ausência de resposta em nenhum item. Conclusão A EDMG é adaptada transculturalmente em diversos países e amplamente utilizada por realizar diagnóstico em faixa etária essencial para estimulação com a plasticidade cerebral em pleno desenvolvimento. Foi realizada a adaptação transcultural da EDMG para o Brasil, transformando o cenário brasileiro em relação à atenção a lactentes. Após normatização e verificação das medidas psicométricas, será possível, além de diagnóstico precoce, melhorar a qualidade dos atendimentos a esta população; realizar estudos transculturais e publicar em revistas internacionais com a viabilidade de a EDMG ser aceita e utilizada internacionalmente.
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Visser L, Vlaskamp C, Emde C, Ruiter SAJ, Timmerman ME. Difference or delay? A comparison of Bayley-III Cognition item scores of young children with and without developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 71:109-119. [PMID: 29032286 DOI: 10.1016/j.ridd.2017.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 09/26/2017] [Accepted: 09/29/2017] [Indexed: 06/07/2023]
Abstract
The "difference or delay paradigm" focuses on the question of whether children with developmental disabilities (DD) develop in a way that is only delayed, compared to typically developing children, or also qualitatively different. The current study aimed to examine whether qualitative differences exist in cognitive development of young children with and without DD on the basis of item scores on the Dutch Bayley-III Cognition scale. Differential item functioning was identified for 15 of the 91 items. The presence of DD was related to a higher number of Guttman errors, hinting at more deviation in the order of skill development. An interaction between group (i.e., with or without DD) and developmental quotient appeared to predict the number of Guttman errors. DD was related to a higher number of Guttman errors for the whole range of developmental quotients; children with DD with a small developmental quotient had the highest number. Combined, the results mean that qualitative differences in development are not to be excluded, especially in cases of severe developmental disabilities. When using the Bayley-III in daily practice, the possibility needs to be taken into account that the instruments' assumption of a fixed order in skill development does not hold.
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Affiliation(s)
- Linda Visser
- German Institute for International Educational Research (DIPF) and Centre for Research on Individual Development and Adaptive Education for Children at Risk (IDeA), Schloßstraße 29, 60486, Frankfurt am Main, Germany.
| | - Carla Vlaskamp
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Special Needs Education and Youth Care, Grote Rozenstraat 38, 9712 TJ Groningen, The Netherlands.
| | - Cornelius Emde
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Psychometrics and Statistics, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
| | - Selma A J Ruiter
- De Kinderacademie Groningen, Herestraat 106, 9711 LM Groningen, The Netherlands.
| | - Marieke E Timmerman
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Psychometrics and Statistics, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
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O'Connor CM, Ryan CA, Boylan GB, Murray DM. The ability of early serial developmental assessment to predict outcome at 5years following neonatal hypoxic-ischaemic encephalopathy. Early Hum Dev 2017; 110:1-8. [PMID: 28433953 DOI: 10.1016/j.earlhumdev.2017.04.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 03/23/2017] [Accepted: 04/05/2017] [Indexed: 11/18/2022]
Abstract
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.
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Affiliation(s)
- Catherine M O'Connor
- Department of Paediatrics and Child Health, University College Cork, Clinical Investigations Unit, Cork University Hospital, Wilton, Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research (INFANT Centre), Department of Paediatrics and Child Health, Cork University Maternity Hospital, Wilton, Cork, Ireland; Neonatal Brain Research Group, University College Cork, Cork University Maternity Hospital, Wilton, Cork, Ireland.
| | - C Anthony Ryan
- Department of Paediatrics and Child Health, University College Cork, Clinical Investigations Unit, Cork University Hospital, Wilton, Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research (INFANT Centre), Department of Paediatrics and Child Health, Cork University Maternity Hospital, Wilton, Cork, Ireland.
| | - Geraldine B Boylan
- Department of Paediatrics and Child Health, University College Cork, Clinical Investigations Unit, Cork University Hospital, Wilton, Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research (INFANT Centre), Department of Paediatrics and Child Health, Cork University Maternity Hospital, Wilton, Cork, Ireland; Neonatal Brain Research Group, University College Cork, Cork University Maternity Hospital, Wilton, Cork, Ireland.
| | - Deirdre M Murray
- Department of Paediatrics and Child Health, University College Cork, Clinical Investigations Unit, Cork University Hospital, Wilton, Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research (INFANT Centre), Department of Paediatrics and Child Health, Cork University Maternity Hospital, Wilton, Cork, Ireland; Neonatal Brain Research Group, University College Cork, Cork University Maternity Hospital, Wilton, Cork, Ireland.
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Milne S, McDonald J, Kayrouz N. Determinants of developmental progress in pre-schoolers referred for neuro-developmental diagnosis. J Paediatr Child Health 2016; 52:1004-1011. [PMID: 27599109 DOI: 10.1111/jpc.13274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/22/2016] [Accepted: 04/13/2016] [Indexed: 11/29/2022]
Abstract
AIM To determine factors associated with change in developmental progress in pre-schoolers referred to a developmental clinic. METHODS Of 360 pre-schoolers referred to a Child Assessment clinic for neuro-developmental diagnosis before 3.6 years, 190 (53%) were reassessed prior to school entry and recruited to this study. They were assessed with the Bayley Scales of Infant and Toddler Development (3rd edn) before 3.5 years and the Griffiths Mental Development Scales before school entry. The influence of medical and environmental variables on improvement or deterioration in scores (±0.5 SD) was examined using logistic regression. RESULTS Consistent scores were present in 51.6% of children, and associated with environmental variables. Children with stable scores were more likely to live in a suburb of social advantage (OR = 3.2; 95%CI = 1.37-7.64, P = 0.008) or to come from families dependent on welfare or public housing (OR=4.8; 95%CI = 2.19-10.49, P < 0.001). Improvement was seen in 18.1% of children; they were more likely to have commenced therapy after the first assessment (OR = 2.4; 95%CI = 1.05-5.58, P = 0.038). Deterioration of scores was seen in 30% of children. Children with a mild delay on initial assessment were less likely to deteriorate (OR = 2.9; 95%CI = 1.16-7.04, P = 0.022), while lower scores were more likely in children with neuro-motor disabilities (OR = 10.8; 95%CI = 2.64-44.58, P < 0.001), and chromosomal variations of both known and unknown significance (OR = 4.4; 95%CI = 1.54-12.76, P = 0.006). CONCLUSIONS Socio-economic advantage and disadvantage are associated with stable scores, but introducing intervention is associated with improved scores. Deterioration is most likely in children with chromosomal variations or neuro-motor disabilities, and regular reassessment of these children is recommended.
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Affiliation(s)
- Susan Milne
- Paediatric Allied Health, Campbelltown Hospital, Sydney, New South Wales, Australia
| | - Jenny McDonald
- Paediatric Allied Health, Campbelltown Hospital, Sydney, New South Wales, Australia
| | - Norma Kayrouz
- Paediatric Allied Health, Campbelltown Hospital, Sydney, New South Wales, Australia
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Picciolini O, Squarza C, Fontana C, Giannì ML, Cortinovis I, Gangi S, Gardon L, Presezzi G, Fumagalli M, Mosca F. Neurodevelopmental outcome of extremely low birth weight infants at 24 months corrected age: a comparison between Griffiths and Bayley Scales. BMC Pediatr 2015; 15:139. [PMID: 26419231 PMCID: PMC4589038 DOI: 10.1186/s12887-015-0457-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/15/2015] [Indexed: 11/10/2022] Open
Abstract
Background The availability of accurate assessment tools for the early detection of infants at risk for adverse neurodevelopmental outcomes is a major issue. The purpose of this study is to compare the outcomes of the Bayley Scales (Bayley-II vs Bayley-III) in a cohort of extremely low birth weight infants at 24 months corrected age, to define which edition shows the highest agreement with the Griffiths Mental Development Scales Revised. Methods We performed a single-centre cohort study. We prospectively enrolled infants with a birth weight of 401–1000 g and/or gestational age < 28 weeks. Exclusion criteria were the presence of neurosensory disabilities and/or genetic abnormalities. Infants underwent neurodevelopmental evaluation at 24 months corrected age using the Griffiths and either the Bayley-II (birth years 2003–2006) or the Bayley-III (birth years 2007–2010). Results A total of 194 infants were enrolled. Concordance was excellent between the Griffiths and the Bayley-III composite scores for both cognitive language and motor abilities (weighted K = 0.80 and 0.81, respectively) but poorer for the Bayley-II (weighted K = 0.63 and 0.50, respectively). The Youden’s Index revealed higher values for the Bayley-III than for the Bayley-II (75.9 vs 69.6 %). Compared with the Griffiths, the Bayley-III found 3 % fewer infants as being severely impaired in cognitive-language abilities and 7.8 % fewer infants as being mildly impaired in motor skills while the Bayley-II showed, compared with the Griffiths, higher rates of severely impaired children both for cognitive-language and motor abilities (14.1 and 15.3 % more infants respectively). Discussion Our study suggests that the Bayley-III, although having a higher agreement with the Griffiths compared to the Bayley-II, slightly tends to underestimate neurodevelopmental impairment compared with the Griffiths, whereas the Bayley-II tends to overestimate it. Conclusions On the basis of these findings, we recommend the use of multiple measures to assess neurodevelopmental outcomes of extremely low birth weight infants at 24 months.
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Affiliation(s)
- Odoardo Picciolini
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, Milan, 20122, Italy.
| | - Chiara Squarza
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, Milan, 20122, Italy.
| | - Camilla Fontana
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, Milan, 20122, Italy.
| | - Maria Lorella Giannì
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, Milan, 20122, Italy.
| | - Ivan Cortinovis
- Department of Clinical Sciences and Community Health-Laboratory of Medical Statistics, Biometry and Epidemiology, Università degli Studi di Milano, Via Della Commenda 12, Milan, 20122, Italy.
| | - Silvana Gangi
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, Milan, 20122, Italy.
| | - Laura Gardon
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, Milan, 20122, Italy.
| | - Gisella Presezzi
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, Milan, 20122, Italy.
| | - Monica Fumagalli
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, Milan, 20122, Italy.
| | - Fabio Mosca
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, Milan, 20122, Italy.
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