EFFECTIVENESS OF THE LACEY ASSESSMENT OF PRETERM INFANTS TO PREDICT NEUROMOTOR OUTCOMES FOR PREMATURE BABIES AT TWELVE MONTHS CORRECTED AGE
DOI:
https://doi.org/10.15621/ijphy/2020/v7i4/744Keywords:
Preterm, Lacey assessment of Preterm Infants, Neuromotor outcome.Abstract
Background: The Lacey Assessment of Preterm Infants (LAPI) is used in clinical practice to identify premature babies at risk of neuromotor impairments, especially cerebral palsy. There is a shortage of studies on the Lacey assessment despite its wide clinical use. This study attempted to find the diagnostic accuracy of the Lacey assessment of preterm infants to predict neuromotor outcomes of premature babies at 12 months corrected age and to compare their predictive ability with brain ultrasound.
Methods: This prospective cohort study included 89 preterm infants (45 females & 44 males) born below 35 weeks gestation. An initial assessment was done using the Lacey Assessment of Preterm Infants (LAPI) after babies reached 33 weeks postmenstrual age. Follow up assessment on neuromotor outcomes was done at 12 months (±1 week) corrected age using two standardized outcome measures, i.e., Infant Neurological International Battery and Alberta Infant Motor Scale. Brain ultrasound data were collected retrospectively. Data were statistically analyzed, and the diagnostic accuracy of the Lacey Assessment of Preterm Infants (LAPI) alone and in combination with brain ultrasound was calculated.
Results: Fisher's exact test showed p<.01, indicating that there is an association between the Lacey Assessment of Preterm Infants (LAPI) and the neuromotor outcomes at one year corrected age. A combination of Lacey Assessment (LAPI) and brain ultrasound results showed higher sensitivity in predicting abnormal neuromotor outcomes than Lacey Assessment alone (80% vs. 66.7%, respectively). Lacey Assessment also showed high specificity (96.3%) and negative predictive value (97.5%).
Conclusion: Results of this study suggest that the Lacey Assessment of Preterm Infants (LAPI) can be used as a supplementary assessment tool for premature babies to identify those at risk of abnormal neuromotor outcomes. These findings have applications to identify premature babies eligible for early intervention services.
References
Moore T, Hennessy EM, Myles J, Johnson SJ, Draper ES, Costeloe KL, Marlow N. Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006. the EPICure studies. BMJ. 2012;345: e7961
Pierrat V, Marchand-Martin L, Arnaud C, Kaminski M, Resche-Rigon M, Lebeaux C et al. Neurodevelopmental outcomes at 2 years for preterm children born at 22-34 weeks gestation in France in 2011: EPIPAGE -2 cohort study. BMJ. 2017;358: j3448
Leroux BG, N'guyen The Tich S, Branger B, Gascoin G, Rouger V, Berlie I et al. Neurological assessment of preterm infants for predicting neuromotor status at 2 years: results from the LIFT cohort. BMJ Open. 2013; 3(2): e002431.
Lacey J, Rudge S, Rieger I, Osborn DA. Assessment of neurological status in preterm infants in neonatal intensive care and prediction of cerebral palsy. Aust J Physiother. 2004;50:137-144.
Marcroft C, Dulson P, Hearn R, Basu A, Embleton N. Does the Lacey Assessment of Preterm Infants predict cerebral palsy in extremely preterm infants? A pilot study. APCP Journal. 2014;5(2).
James PW, Basu A, Marcroft C. Lacey Assessment of Preterm Infants. J Physiother. 2017;63(4):267.
Lacey JL, Brady A, Smith P. The Lacey Assessment of Preterm Infants - Course Manual. Association of Pediatric Chartered Physiotherapists, 2015.
Darrah J, Piper M, Watt MJ. Assessment of gross motor skills of at‐risk infants: predictive validity of the Alberta Infant Motor Scale. Dev Med Child Neurol. 1998; 40(7): 485-491
Song YH, Chang HJ, Shin YB, Park YS, Park YH, Cho ES. The validity of two neuromotor assessments for predicting neuromotor performance at 12 months in preterm infants. Ann Rehabil Med. 2018;42(2):296-304.
Marret S, Marchand-Martin L, Picaud J-C, Hascoet J-M, Arnaud C, Roze J-C, et al. Brain Injury in very preterm children and neurosensory and cognitive disabilities during childhood: The EPIPAGE cohort Study. PLoS ONE. 2013; 8(5): e62683.
Spittle AJ, Cameron K, Doyle LW, Cheong JL. Motor Impairment trends in extremely preterm children: 1991– 2005. Pediatrics. 2018;141(4): e20173410.
Williams J, Lee KJ, Anderson PJ. Prevalence of motor-skill impairment in preterm children who do not develop cerebral palsy: a systematic review. Dev Med Child Neurol. 2010;52(3):232-7.
Harmon H, Taylor HG, Minich N, Wilson-Costello D, Hack M. Early school outcomes for extremely preterm infants with transient neurological abnormalities. Dev Med Child Neurol. 2015; 57(9): 865–871.
Ellison PH, Horn JL, Browning CA. Construction of an Infant Neurological International Battery for the assessment of neurological integrity in infancy. Physical Therapy .1985; 65(9):1326-31.
Soleimani F, Dadkhah J. Validity and reliability of Infant Neurological International Battery for detection of gross motor developmental delay in Iran. Child Care Health Dev. 2007;33(3):262-5.
Sung Y, Kang W. Infant Neurological International Battery as a predictor of neuromotor outcome in risk infants. J Korean Acad Rehabil Med .1997; 21 (2) :406-413.
Albuquerque PL, Guerra MQF, Lima MC, Eickmann SH. Concurrent validity of the Alberta Infant Motor Scale to detect delayed gross motor development in preterm infants: A comparative study with the Bayley III. Dev Neurorehabil.2018;21(6):408–414.
Fuentefria RDN, Silveira RC, Procianoy RS. Motor development of preterm infants assessed by the Alberta Infant Motor Scale: systematic review article. J Pediatr (Rio J). 2017;93(4):328–342.
Spittle AJ. How do we use the assessment of general movements in clinical practice? Dev Med Child Neurol. 2011;53(8):681-2.
Spittle AJ, Cheong J, Doyle LW, Roberts G, Lee KJ, Lim J, Hunt RW, et al. Neonatal white matter abnormality predicts childhood motor impairment in very preterm children. Dev Med Child Neurol .2011;53:1000–6.
Published
Abstract Display: 895 
PDF Downloads: 630 How to Cite
Issue
Section
Copyright © Author(s) retain the copyright of this article.
This work is licensed under a