Predicting school readiness from neurodevelopmental assessments at age 2 years after respiratory distress syndrome in infants born preterm.
OBJECTIVE
To determine whether neurodevelopmental outcomes at the age of 2 years accurately predict school readiness in children who survived respiratory distress syndrome after preterm birth.


METHODS
Our cohort included 121 preterm infants who received surfactant and ventilation and were enrolled in a randomized controlled study of inhaled nitric oxide for respiratory distress syndrome. Abnormal outcomes at the age of 2 years were defined as neurosensory disability (cerebral palsy, blindness, or bilateral hearing loss) or delay (no neurosensory disability but Bayley Scales of Infant Development mental or performance developmental index scores <70). School readiness (assessed at a mean age of 5y 6mo, SD 1y) was determined using neurodevelopmental assessments of motor, sensory, receptive vocabulary, perceptual, conceptual, and adaptive skills.


RESULTS
The mean birthweight of the cohort (57 males, 64 females) was 987g (SD 374), and the mean gestational age was 27.3 weeks (SD 2.6). At the age of 2 years, the neurodevelopmental classification was 'disabled' in 11% and 'delayed' in 23%. At the age of 5 years 6 months, intensive special education was required for 11% and some special education for 21%. Disability and delay at the age of 2 years were 92% and 50% predictive of lack of school readiness respectively, whereas only 15% of children who were normal at the age of 2 years were not school ready at the later assessment. Children with delay at 2 years were more likely to need special education if they were socially disadvantaged.


CONCLUSIONS
Without preschool developmental supports, preterm survivors living in poverty will require more special education services.
Patrianakos-Hoobler
Athena I
AI
Department of Pediatrics, University of Chicago Comer Children's Hospital and LaRabida Children's Hospital, IL, USA.
Msall
Michael E
ME
Huo
Dezheng
D
Marks
Jeremy D
JD
Plesha-Troyke
Susan
S
Schreiber
Michael D
MD
D000367:Age Factors; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D016001:Confidence Intervals; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D047928:Premature Birth / Q000503:physiopathology*; D012372:ROC Curve; D011932:Reading; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications* / Q000175:diagnosis*; D012923:Social Class