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Predictive validity of the Lacey Assessment of Preterm Infants for motor outcome at 2 years corrected age

Research output: Contribution to journalArticlepeer-review

Anna Lukens, Naomi Winfield, Charlotte Xanthidis, Tomoki Arichi

Original languageEnglish
Article number105334
JournalEarly Human Development
Volume155
DOIs
Accepted/In press9 Feb 2021
PublishedApr 2021

Bibliographical note

Funding Information: The authors would like to acknowledge the tutors and lecturers at University College London, Faculty of Population Health Sciences, for their expertise and support throughout the Advanced Paediatric Physiotherapy MSc course. The authors also acknowledge support from the Department of Health via the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre award to Guy's & St Thomas' NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust. Funding Information: AL is supported through funding from the Engineering and Physical Sciences Research Council (EPSRC) UK [ EP/S013601/1 ]. TA is supported by a Medical Research Council (MRC) Clinician Scientist fellowship [ MR/P008712/1 ]. Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

Documents

  • Manuscript revised

    Manuscript_revised.pdf, 262 KB, application/pdf

    Uploaded date:17 Feb 2021

    Version:Accepted author manuscript

King's Authors

Abstract

Introduction: The Lacey Assessment of Preterm Infants (LAPI) is a clinical tool used to assess neuromotor development in preterm infants at high risk of developmental problems. The aim of this study was to determine its predictive validity for estimating later motor outcome at 2 years of age, to ensure appropriate referral to early intervention and thus optimise the infant's outcome. Method: LAPI outcomes (usual or monitor) for preterm infants born between January 2012–2017 at a single tertiary level neonatal intensive care unit in London, UK were retrospectively reviewed. Predictive validity for later “moderate/severe” motor delay was determined by comparing LAPI outcomes with locomotor scores estimated using the Griffiths Mental Development Scales-Extended Revised (GMDS-ER) or Griffiths III at 2 years corrected age. Results: 118 infants were included (GMDS-ER = 87, Griffiths III = 31). Infants classified as usual on the LAPI showed significantly less motor delay on the GMDS-ER locomotor subset at 2 years, compared to infants in the monitor group (usual = 2.00 months, monitor = 6.00 months; p = 0.001). Sensitivity was found to be only 47.37%, with higher specificity of 84.85%. Conclusion: The LAPI shows high specificity but low sensitivity for prediction of later motor delay. It may therefore be useful for screening lower-risk infants, however on-going monitoring would be advised. Further studies investigating the reliability of the LAPI and use in conjunction with other predictive tools to improve sensitivity are recommended.

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