title: Predicting developmental outcomes in very preterm infants: validity of a neonatal neurobehavioral assessment.
abstract: OBJECTIVE
  This study explored inter-rater reliability, discriminative, construct and predictive validity of the Neurobehavioral Assessment of the Preterm Infant (NAPI) in a gestational-age-based cohort.
  
  
  METHODS
  The NAPI was conducted at 35 weeks post-menstrual age for 170 infants born <32 weeks. Cognitive and motor development was assessed at 2 years using the Mental Development Index (MDI) and Psychomotor Development Index (PDI) of Bayley Scales of Infant Development-II for 159 infants.
  
  
  RESULTS
  Only NAPI motor and irritability scores were significantly different between very (29-3 w) and extremely preterm (<28 w) infants. Results regarding construct validity were variable: there were weak correlations between NAPI motor scores and gestational age (r = -0.23; p = 0.003), days in NICU (r = -0.24; p = 0.001); NAPI alertness scores and days in NICU (r = -0.16; p = 0.037); and NAPI irritability scores and gestational age (r = 0.21; p = 0.006). There were no significant associations with other markers of adverse outcome. Only NAPI irritability scores were correlated with MDI scores (r = -0.16; p = 0.040) but accounted for little additional variance after adjustment for neonatal factors (ΔR(2) = 0.035; p = 0.012).
  
  
  CONCLUSIONS
  We found little evidence of the utility of the NAPI as a measure of short-term neurobehavioural function or for predicting neurodevelopmental outcomes in very preterm infants. It may have greater predictive power when used serially to detect delayed neurobehavioural maturation.
authors.affiliation: Department of Health Sciences, University of Leicester, UK.
authors.forename: Pooja
authors.initials: P
authors.lastname: Harijan
authors.forename: Charlotte
authors.initials: C
authors.lastname: Beer
authors.forename: Cris
authors.initials: C
authors.lastname: Glazebrook
authors.forename: Chrissie
authors.initials: C
authors.lastname: Israel
authors.forename: Neil
authors.initials: N
authors.lastname: Marlow
authors.forename: Andrew
authors.initials: A
authors.lastname: Whitelaw
authors.forename: Samantha
authors.initials: S
authors.lastname: Johnson
mesh_terms: D002657:Child Development; D002675:Child, Preschool; D003071:Cognition; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology*; D007508:Irritable Mood; D008297:Male; D009048:Motor Skills; D009483:Neuropsychological Tests; D015588:Observer Variation; D015203:Reproducibility of Results