Abstract
Our goals were to (1) validate the parental Ages and Stages Questionnaires (ASQ) as a screening tool for psychomotor development among a cohort of ex-premature infants reaching 2 years, and (2) analyse the influence of parental socio-economic status and maternal education on the efficacy of the questionnaire. A regional population of 703 very preterm infants (<35 weeks gestational age) born between 2003 and 2006 were evaluated at 2 years by their parents who completed the ASQ, by a pediatric clinical examination, and by the revised Brunet Lezine psychometric test with establishment of a DQ score. Detailed information regarding parental socio-economic status was available for 419 infants. At 2 years corrected age, 630 infants (89.6%) had an optimal neuromotor examination. Overall ASQ scores for predicting a DQ score ≤85 produced an area under the receiver operator curve value of 0.85 (95% Confidence Interval:0.82–0.87). An ASQ cut-off score of ≤220 had optimal discriminatory power for identifying a DQ score ≤85 with a sensitivity of 0.85 (95%CI:0.75–0.91), a specificity of 0.72 (95%CI:0.69–0.75), a positive likelihood ratio of 3, and a negative likelihood ratio of 0.21. The median value for ASQ was not significantly associated with socio-economic level or maternal education. ASQ is an easy and reliable tool regardless of the socio-economic status of the family to predict normal neurologic outcome in ex-premature infants at 2 years of age. ASQ may be beneficial with a low-cost impact to some follow-up programs, and helps to establish a genuine sense of parental involvement.
Highlights
Developmental outcome of preterm infants is a worthwhile concern for clinicians and research teams
Detailed information regarding parental socio-economic status was available for 419 infants
Our study of a large population-based cohort demonstrates that parental completion of ASQ is a simple, valid and cost-effective means of screening for normal neurodevelopmental outcome among ex-premature infants at 2 years of age
Summary
Developmental outcome of preterm infants is a worthwhile concern for clinicians and research teams. Detection of nonoptimal neurodevelopment is essential for timely intervention in order to correct or attenuate problems Standardized tests such as the Bayley scale, or in France the revised Brunet-Lezine scale [1], provide efficient measures of outcome. The Ages and Stages Questionnaires (ASQ) constitute a screening method of monitoring children who are at risk for developmental delay [11] This structured questionnaire involving five domains of development has been shown to be cross-culturally valid between the United States and other Western settings [12]. A cohort of 703 ex-premature infants reaching 2 years gave us the opportunity to (i) validate the ASQ as a screening tool for abnormal development quotient in a French-speaking population, and (ii) analyse the influence of parental socio-economic status on the efficacy of the questionnaire
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