EFFECTIVENESS OF THE LACEY ASSESSMENT OF PRETERM INFANTS TO PREDICT NEUROMOTOR OUTCOMES FOR PREMATURE BABIES AT TWELVE MONTHS CORRECTED AGE

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, 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.