Article

In this study, we evaluated the Clinical Risk Index for Babies - revised
(CRIB-II) score as a predictor of long-term neurodevelopmental outcomes in
preterm infants at 36 months' corrected age. METHOD: CRIB-II scores, which
include birthweight, gestational age, sex, admission temperature, and base
excess, were recorded prospectively on all infants weighing 1250g or less
admitted to the neonatal intensive care unit (NICU). The sensitivity and
specificity of CRIB-II scores to predict poor outcomes were examined using
receiver operating characteristic curves, and predictive accuracy was assessed
using the area under the curve (AUC), based on the observed values entered on a
continuous scale. Poor outcomes were defined as death or major neurodevelopmental
disability (cerebral palsy, neurosensory hearing loss requiring amplification,
legal blindness, severe seizure disorder, or cognitive score >2SD below the mean
for adjusted age determined by clinical neurological examination and on the
Wechsler Preschool and Primary Scale of Intelligence, Bayley Scales of Infant
Development, or revised Leiter International Performance Scale). RESULTS: Of the
180 infants admitted to the NICU, 155 survived. Complete follow-up data were
available for 107 children. The male:female ratio was 50:57 (47-53%), median
birthweight was 930g (range 511-1250g), and median gestational age was 27 weeks
(range 23-32wks). Major neurodevelopmental impairment was observed in 11.2% of
participants. In a regression model, the CRIB-II score was significantly
correlated with long-term neurodevelopmental outcomes. It predicted major
neurodevelopmental impairment (odds ratio [OR] 1.57, bootstrap 95% confidence
interval [CI] 1.26-3.01; AUC 0.84) and poor outcome (OR 1.46; bootstrap 95% CI
1.31-1.71, AUC 0.82) at 36 months' corrected age. INTERPRETATION: CRIB-II scores
of 13 or more in the first hour of life can reliably predict major
neurodevelopmental impairment at 36 months' corrected age (sensitivity 83%;
specificity 84%).

Langue : ANGLAIS