Do currently recommended Bayley-III cutoffs overestimate motor impairment in infants born <27 weeks gestation?

• Published in: Journal of perinatology Vol. 35; no. 7; pp. 516 - 521
• Main Authors: Duncan, A F, Bann, C, Boatman, C, Hintz, S R, Vaucher, Y E, Vohr, B R, Yolton, K, Heyne, R J
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-07-2015; Nature Publishing Group
• Subjects: 692/308/409; 692/699/375/2764; 692/700/1720; Abnormalities; Age; Cerebral palsy; Child Development - classification; Children & youth; Childrens health; Diagnosis; Evaluation; Female; Gestation; Gestational Age; Health aspects; Humans; Impairment; Infant, Extremely Premature - physiology; Infant, Newborn; Infants; Infants (Newborn); Male; Medical examination; Medicine; Medicine & Public Health; Motor skills; Motor Skills Disorders - diagnosis; Neonates; Neurology; Neuropsychological Tests; Newborn infants; original-article; Pediatric research; Pediatric Surgery; Pediatrics; Practice guidelines (Medicine); Predictive Value of Tests; Preschool children; Psychomotor disorders; Regression analysis; Retrospective Studies; Risk factors; Sensitivity analysis; Sensitivity and Specificity; Statistical analysis; United States
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2014.243

Objective:
To determine whether a Bayley-III motor composite score of 85 may overestimate moderate–severe motor impairment by analyzing Bayley-III motor components and developing cut-point scores for each.
Study Design:
Retrospective study of 1183 children born <27 weeks gestation at NICHD Neonatal Research Network centers and evaluated at 18–22 months corrected age. Gross Motor Function Classification System determined gross motor impairment. Statistical analyses included linear and logistic regression and sensitivity/specificity.
Results:
Bayley-III motor composite scores were strong indicators of gross/fine motor impairment. A motor composite cut-point of 73 markedly improved the specificity for identifying gross and/or fine motor impairment (94% compared with a specificity of 76% for the proposed new cut-point of 85). A Fine Motor Scaled Score <3 differentiated mild from moderate–severe fine motor impairment.
Conclusions:
This study indicates that a Bayley-III motor composite score of 85 may overestimate impairment. Further studies are needed employing term controls and longer follow-up.