Do Bayley-III composite scores at 18-22 months corrected age predict full-scale IQ at 6-7 years in children born extremely preterm?

Abhik Das; Carla M. Bann; Jean Lowe; Carla M Bann; Allison Dempsey; Janell Fuller; H Gerry Taylor; Kathryn E Gustafson; Victoria E Watson; Betty R Vohr; Abhik Das; Seetha Shankaran; Kimberly Yolton; M Bethany Ball; Susan R Hintz

Do Bayley-III composite scores at 18-22 months corrected age predict full-scale IQ at 6-7 years in children born extremely preterm?

Lowe, J., Bann, C. M., Dempsey, A. G., Fuller, J., Taylor, H. G., Gustafson, K. E., Watson, V. E., Vohr, B. R., Das, A., Shankaran, S., Yolton, K., Ball, M. B., Hintz, S. R., & Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (2023). Do Bayley-III composite scores at 18-22 months corrected age predict full-scale IQ at 6-7 years in children born extremely preterm? The Journal of Pediatrics, 263, Article 113700. https://doi.org/10.1016/j.jpeds.2023.113700

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Abstract

OBJECTIVE: To determine the ability of the Bayley-III cognitive and language composite scores at 18-22 months corrected age to predict WISC-IV Full Scale IQ (FSIQ) at 6-7 years in infants born extremely preterm.

STUDY DESIGN: Children in this study were part of the Neuroimaging and Neurodevelopmental Outcome (NEURO) cohort, a secondary study to the SUPPORT trial and born 24 to 27.6 weeks gestational age. Bayley-III cognitive and language scores and WISC-IV FSIQ were compared with pairwise Pearson correlation coefficients and adjusted for medical and socio-economic variables using linear mixed effect regression models.

RESULTS: Bayley-III cognitive (r=0.33) and language scores (r=0.44) were mildly correlated with WISC-IV FSIQ score. Of the children with Bayley-III cognitive scores less than 70, 67% also had FSIQ <70. There was less consistency for children with Bayley-III scores in the 85-100 range as 43% had FSIQ <85 and 10% FSIQ <70. Among those with Bayley-III language scores >100, about 1 in 5 had FSIQ <85. A cut point of 92 for the cognitive composite score resulted in sensitivity (0.60), specificity (0.64). A cut point of 88 for the language composite score produced sensitivity (0.61), specificity (0.70).

CONCLUSION: Findings indicate the Bayley-III cognitive and language scores correlate with later IQ but may fail to predict delay or misclassify children who are not delayed at school age. The Bayley-III can be a useful tool to help identify children born extremely preterm who have below average cognitive scores and may be at the greatest risk for ongoing cognitive difficulties.