Article

Extremely preterm and extremely low-birthweight (EP/ELBW) children (<28
completed weeks' gestation; birthweight <1000g) have a high risk of long-term
adverse outcomes. Clinical developmental surveillance is difficult to achieve for
all of these children. Our aim was to study the ability of two parent-completed
questionnaires to differentiate health status of EP/ELBW children from that of a
comparison group of children born at term, and to screen EP/ELBW children for
disability compared with the ability of a multidisciplinary clinical assessment.
METHOD: A geographic cohort of 189 EP/ELBW children (100 males, 89 females) and a
comparison group of 173 term children (92 males, 81 females) born in 1997 were
assessed at the age of 8 years using parent questionnaires (the Child Health
Questionnaire [CHQ] and the Health Utilities Index Mark 2 [HUI2]) and a
multidisciplinary clinical assessment. The questionnaires and clinical assessment
were compared with respect to their ability to differentiate between the health
status of EP/ELBW children and children born at term and also to identify
children with a disability. RESULTS: The HUI2 was better than the CHQ at
differentiating the health status of EP/ELBW and comparison children. Moderate
and severe disability status were identified by the HUI2 with sensitivity ranging
from 86 to 97%, specificity from 60 to 64%, positive predictive values from 34 to
39%, and negative predictive values from 95 to 99%. INTERPRETATION: The HUI2 had
suitable sensitivity and specificity to be used as a developmental screening tool
for EP/ELBW children, but the CHQ did not. Given its low positive predictive
values, however, the HUI2 should be viewed with caution as a final outcome
measure for intervention trials, and would be better used to identify at-risk
children who need a definitive clinical assessment.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith
Press.

Langue : ANGLAIS