title: Are outcomes of extremely preterm infants improving? Impact of Bayley assessment on outcomes.
abstract: OBJECTIVE
  To compare 18- to 22-month cognitive scores and neurodevelopmental impairment (NDI) in 2 time periods using the National Institute of Child Health and Human Development's Neonatal Research Network assessment of extremely low birth weight infants with the Bayley Scales of Infant Development, Second Edition (Bayley II) in 2006-2007 (period 1) and using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), with separate cognitive and language scores, in 2008-2011 (period 2).
  
  
  METHODS
  Scores were compared with bivariate analysis, and regression analyses were run to identify differences in NDI rates.
  
  
  RESULTS
  Mean Bayley III cognitive scores were 11 points higher than mean Bayley II cognitive scores. The NDI rate was reduced by 70% (from 43% in period 1 to 13% in period 2; P < .0001). Multivariate analyses revealed that Bayley III contributed to a decreased risk of NDI by 5 definitions: cognitive score <70 and <85, cognitive or language score <70; cognitive or motor score <70, and cognitive, language, or motor score <70 (P < .001).
  
  
  CONCLUSIONS
  Whether the Bayley III is overestimating cognitive performance or whether it is a more valid assessment of emerging cognitive skills than the Bayley II is uncertain. Because the Bayley III identifies significantly fewer children with disability, it is recommended that all extremely low birth weight infants be offered early intervention services at the time of discharge from the neonatal intensive care unit, and that Bayley scores be interpreted with caution.
authors.affiliation: Department of Pediatrics, Women & Infants' Hospital, Brown University, Providence, RI 02905, USA. bvohr@wihri.org
authors.forename: Betty R
authors.initials: BR
authors.lastname: Vohr
authors.forename: Bonnie E
authors.initials: BE
authors.lastname: Stephens
authors.forename: Rosemary D
authors.initials: RD
authors.lastname: Higgins
authors.forename: Carla M
authors.initials: CM
authors.lastname: Bann
authors.forename: Susan R
authors.initials: SR
authors.lastname: Hintz
authors.forename: Abhik
authors.initials: A
authors.lastname: Das
authors.forename: Jamie E
authors.initials: JE
authors.lastname: Newman
authors.forename: Myriam
authors.initials: M
authors.lastname: Peralta-Carcelen
authors.forename: Kimberly
authors.initials: K
authors.lastname: Yolton
authors.forename: Anna M
authors.initials: AM
authors.lastname: Dusick
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Evans
authors.forename: Ricki F
authors.initials: RF
authors.lastname: Goldstein
authors.forename: Richard A
authors.initials: RA
authors.lastname: Ehrenkranz
authors.forename: Athina
authors.initials: A
authors.lastname: Pappas
authors.forename: Ira
authors.initials: I
authors.lastname: Adams-Chapman
authors.forename: Deanne E
authors.initials: DE
authors.lastname: Wilson-Costello
authors.forename: Charles R
authors.initials: CR
authors.lastname: Bauer
authors.forename: Anna
authors.initials: A
authors.lastname: Bodnar
authors.forename: Roy J
authors.initials: RJ
authors.lastname: Heyne
authors.forename: Yvonne E
authors.initials: YE
authors.lastname: Vaucher
authors.forename: Robert G
authors.initials: RG
authors.lastname: Dillard
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Acarregui
authors.forename: Elisabeth C
authors.initials: EC
authors.lastname: McGowan
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Myers
authors.forename: Janell
authors.initials: J
authors.lastname: Fuller
mesh_terms: D003071:Cognition; D002658:Developmental Disabilities / Q000175:diagnosis*; D005865:Gestational Age; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology; D007804:Language Development; D009483:Neuropsychological Tests