Parent-Completed Developmental Screening in Premature Children: A Valid Tool for Follow-Up Programs

Our goals were to (1) validate the parental Ages and Stages Questionnaires (ASQ) as a screening tool for psychomotor development among a cohort of ex-premature infants reaching 2 years, and (2) analyse the influence of parental socio-economic status and maternal education on the efficacy of the questionnaire. A regional population of 703 very preterm infants (<35 weeks gestational age) born between 2003 and 2006 were evaluated at 2 years by their parents who completed the ASQ, by a pediatric clinical examination, and by the revised Brunet Lezine psychometric test with establishment of a DQ score. Detailed information regarding parental socio-economic status was available for 419 infants. At 2 years corrected age, 630 infants (89.6%) had an optimal neuromotor examination. Overall ASQ scores for predicting a DQ score ≤85 produced an area under the receiver operator curve value of 0.85 (95% Confidence Interval:0.82–0.87). An ASQ cut-off score of ≤220 had optimal discriminatory power for identifying a DQ score ≤85 with a sensitivity of 0.85 (95%CI:0.75–0.91), a specificity of 0.72 (95%CI:0.69–0.75), a positive likelihood ratio of 3, and a negative likelihood ratio of 0.21. The median value for ASQ was not significantly associated with socio-economic level or maternal education. ASQ is an easy and reliable tool regardless of the socio-economic status of the family to predict normal neurologic outcome in ex-premature infants at 2 years of age. ASQ may be beneficial with a low-cost impact to some follow-up programs, and helps to establish a genuine sense of parental involvement

Traitement du trouble hyperactivité/déficit d'attention par méthylphénidate à libération prolongée versus méthylphénidate à libération immédiate (Résultats d'une enquête prospective chez vingt-trois patients)

ANGERS-BU Médecine-Pharmacie (490072105) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Cohort Profile: Longitudinal study of preterm infants in the Pays de la Loire region of France (LIFT cohort)

International audienc

Neonatal EEG and neurodevelopmental outcome in preterm infants born before 32 weeks

International audienceObjective To assess the value of neonatal EEG for predicting non-optimal neurodevelopmental outcomes in very preterm infants, using a multimodal strategy of evaluation comprising brain imaging and clinical assessment. Design and setting Between 2003 and 2009, we performed an observational, population-based study. Out of 2040 eligible preterm infants born before 32 weeks, 1954 were enrolled in the French regional Loire Infant Follow-Up Team (LIFT) cohort. 1744 (89%) of these completed the follow-up. Neonatal EEGs were recorded prospectively as two EEGs during the first 2 weeks of life and then one every 2 weeks up to 33 weeks. Main outcome measures The neurodevelopmental outcome was assessed by physical examination, the Brunet–Lézine Test and/or the Age and Stages Questionnaire at 2 years of corrected age. Results Of the 1744 infants assessed at 2 years, 422 had a non-optimal outcome. A total of 4804 EEGs were performed, and 1345 infants had at least one EEG. EEG abnormalities were predictive of non-optimal outcomes after controlling for confounding factors such as severe intracranial lesions detected by brain imaging. Transient moderate and severe abnormalities were independent predictors of non-optimal outcomes with an OR and 95% CI of 1.49 (1.08 to 2.04) and 2.38 (1.49 to 3.81), respectively. In the validation group, the predictive risk stratification tree identified severe abnormalities as a factor contributing to the prognosis of two subgroups: infants with severe cranial lesions and infants with a normal examination at discharge and without severe cranial lesions

Receiver operating characteristic curve (ROC) for prediction of Development Quotient score ≤85 from ASQ.

<p>Arrow denotes optimal predictive value (ASQ score of 220).</p

Characteristics of the population studied (n = 703).

<p>DQ: Developmental Quotient (revised Brunet Lezine scale); ASQ: Ages and Stages Questionnaires;</p><p>*cut-off value for a positive screen is 2 SD below the mean on ASQ.</p

Cohort profile.

<p>Cohort profile.</p

Developmental quotient and ASQ score in relation to a family's socio-demographic characteristics.

<p>ASQ: Ages and Stages Questionnaires; DQ: Developmental Quotient.</p

Cross-tabulation of developmental classification using ASQ and DQ scores assessed by the revised Brunet-Lezine scale.

<p>ASQ: Ages and Stages Questionnaires; DQ: Developmental Quotient; <i>% Sensitivity</i>, percent of “delayed” infants detected by the screening test as “delayed”; <i>% Specificity</i>, percent of “normally developing” infants detected by the screening test as “normal”.</p