Sensitivity and specificity of the Neonatal Visual Assessment to predict motor and cognitive outcomes in infants born very preterm

Journal article

Blazek, Jessica W., Colditz, Paul B., Guzzetta, Andrea, Ware, Robert S., Chatfield, Mark D., Hough, Judith L., Boyd, Roslyn N. and George, Joanne M.. (2024). Sensitivity and specificity of the Neonatal Visual Assessment to predict motor and cognitive outcomes in infants born very preterm. Early Human Development. 195, p. Article 106068. https://doi.org/10.1016/j.earlhumdev.2024.106068
AuthorsBlazek, Jessica W., Colditz, Paul B., Guzzetta, Andrea, Ware, Robert S., Chatfield, Mark D., Hough, Judith L., Boyd, Roslyn N. and George, Joanne M.
Abstract

Background
Very preterm infants are at increased risk of neurodevelopmental impairments. The Neonatal Visual Assessment (NVA) assesses visual function and outcomes and has been used to assess early neurodevelopmental outcomes. This study aimed to compare NVA results of very preterm and term-born infants and to calculate the sensitivity and specificity of the NVA at term equivalent age (TEA) and three months corrected age (CA) to predict motor and cognitive outcomes at 12 months CA in very preterm infants.

Methods
This prospective observational cohort study recruited infants born before 31 weeks gestation and a healthy term-born control group. The NVA was assessed at TEA and three months CA, and neurodevelopmental outcomes (Bayley Scales of Infant and Toddler Development, Third Edition; Neurosensory Motor Developmental Assessment; Alberta Infant Motor Scale) were performed at 12 months CA. The sensitivity and specificity of the NVA to predict outcomes were calculated based on a previously published optimality score.

Results
248 preterm (54 % male) and 46 term-born infants (48 % male) were analysed. The mean NVA scores of preterm and term-born infants were significantly different at TEA (preterm 3.1
2.1; term-born 1.2
1.7, p < 0.001). The NVA had moderate sensitivity (59–78 %) and low specificity (25–27 %) at TEA, and low sensitivity (21–28 %) and high specificity (86–87 %) at three months CA for the prediction of preterm infants' outcomes at 12 months CA.

Conclusion
The NVA at TEA and three months CA was not a strong predictor of motor and cognitive impairments in this contemporary cohort of very preterm infants.

Keywordsinfant, premature; vision screening; neurodevelopment; cohort study
Year2024
JournalEarly Human Development
Journal citation195, p. Article 106068
PublisherElsevier B.V.
ISSN0378-3782
Digital Object Identifier (DOI)https://doi.org/10.1016/j.earlhumdev.2024.106068
PubMed ID38968818
Scopus EID2-s2.0-85159615679
Open accessPublished as ‘gold’ (paid) open access
Page range1-9
FunderCerebral Palsy Alliance Research Foundation
Financial Markets Foundation for Children
Queensland Government
National Health and Medical Research Council (NHMRC)
University of Queensland (UQ)
Italian Ministry of Health
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online04 Jul 2024
Publication process dates
Accepted14 Jun 2024
Deposited05 May 2025
Grant IDIRG1413
2014-074
1084032
1105038
1195602
1116442
Additional information

© 2024 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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