TY - JOUR
T1 - INTERGROWTH-21st Project international INTER-NDA standards for child development at 2 years of age
T2 - an international prospective population-based study
AU - Fernandes, Michelle
AU - Villar, José
AU - Stein, Alan
AU - Staines Urias, Eleonora
AU - Garza, Cutberto
AU - Victora, Cesar G.
AU - Barros, Fernando C.
AU - Bertino, Enrico
AU - Purwar, Manorama
AU - Carvalho, Maria
AU - Giuliani, Francesca
AU - Wulff, Katharina
AU - Abubakar, Amina A.
AU - Kihara, Michael
AU - Cheikh Ismail, Leila
AU - Aranzeta, Luis
AU - Albernaz, Elaine
AU - Kunnawar, Naina
AU - Di Nicola, Paola
AU - Ochieng, Roseline
AU - Sandells, Tamsin
AU - Savini, Sandy
AU - Temple, Sophie
AU - Murray, Elizabeth
AU - Ohuma, Eric O.
AU - Gravett, Michael G.
AU - Pang, Ruyan
AU - Jaffer, Yasmine A.
AU - Noble, Julia Alison
AU - Winsey, Adele
AU - Lambert, Ann
AU - Papageorghiou, Aris T.
AU - Bhutta, Zulfiqar
AU - Kennedy, Stephen
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
PY - 2020/6/7
Y1 - 2020/6/7
N2 - OBJECTIVES: To describe the construction of the international INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) standards for child development at 2 years by reporting the cognitive, language, motor and behaviour outcomes in optimally healthy and nourished children in the INTERGROWTH-21st Project. DESIGN: Population-based cohort study, the INTERGROWTH-21st Project. SETTING: Brazil, India, Italy, Kenya and the UK. PARTICIPANTS: 1181 children prospectively recruited from early fetal life according to the prescriptive WHO approach, and confirmed to be at low risk of adverse perinatal and postnatal outcomes. PRIMARY MEASURES: Scaled INTER-NDA domain scores for cognition, language, fine and gross motor skills and behaviour; vision outcomes measured on the Cardiff tests; attentional problems and emotional reactivity measured on the respective subscales of the preschool Child Behaviour Checklist; and the age of acquisition of the WHO gross motor milestones. RESULTS: Scaled INTER-NDA domain scores are presented as centiles, which were constructed according to the prescriptive WHO approach and excluded children born preterm and those with significant postnatal/neurological morbidity. For all domains, except negative behaviour, higher scores reflect better outcomes and the threshold for normality was defined as ≥10th centile. For the INTER-NDA's cognitive, fine motor, gross motor, language and positive behaviour domains these are ≥38.5, ≥25.7, ≥51.7, ≥17.8 and ≥51.4, respectively. The threshold for normality for the INTER-NDA's negative behaviour domain is ≤50.0, that is, ≤90th centile. At 22-30 months of age, the cohort overlapped with the WHO motor milestone centiles, showed low postnatal morbidity (<10%), and vision outcomes, attentional problems and emotional reactivity scores within the respective normative ranges. CONCLUSIONS: From this large, healthy and well-nourished, international cohort, we have constructed, using the WHO prescriptive methodology, international INTER-NDA standards for child development at 2 years of age. Standards, rather than references, are recommended for population-level screening and the identification of children at risk of adverse outcomes.
AB - OBJECTIVES: To describe the construction of the international INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) standards for child development at 2 years by reporting the cognitive, language, motor and behaviour outcomes in optimally healthy and nourished children in the INTERGROWTH-21st Project. DESIGN: Population-based cohort study, the INTERGROWTH-21st Project. SETTING: Brazil, India, Italy, Kenya and the UK. PARTICIPANTS: 1181 children prospectively recruited from early fetal life according to the prescriptive WHO approach, and confirmed to be at low risk of adverse perinatal and postnatal outcomes. PRIMARY MEASURES: Scaled INTER-NDA domain scores for cognition, language, fine and gross motor skills and behaviour; vision outcomes measured on the Cardiff tests; attentional problems and emotional reactivity measured on the respective subscales of the preschool Child Behaviour Checklist; and the age of acquisition of the WHO gross motor milestones. RESULTS: Scaled INTER-NDA domain scores are presented as centiles, which were constructed according to the prescriptive WHO approach and excluded children born preterm and those with significant postnatal/neurological morbidity. For all domains, except negative behaviour, higher scores reflect better outcomes and the threshold for normality was defined as ≥10th centile. For the INTER-NDA's cognitive, fine motor, gross motor, language and positive behaviour domains these are ≥38.5, ≥25.7, ≥51.7, ≥17.8 and ≥51.4, respectively. The threshold for normality for the INTER-NDA's negative behaviour domain is ≤50.0, that is, ≤90th centile. At 22-30 months of age, the cohort overlapped with the WHO motor milestone centiles, showed low postnatal morbidity (<10%), and vision outcomes, attentional problems and emotional reactivity scores within the respective normative ranges. CONCLUSIONS: From this large, healthy and well-nourished, international cohort, we have constructed, using the WHO prescriptive methodology, international INTER-NDA standards for child development at 2 years of age. Standards, rather than references, are recommended for population-level screening and the identification of children at risk of adverse outcomes.
KW - community child health
KW - developmental neurology & neurodisability
KW - epidemiology
KW - paediatrics
UR - http://www.scopus.com/inward/record.url?scp=85086299173&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2019-035258
DO - 10.1136/bmjopen-2019-035258
M3 - Article
C2 - 32513882
AN - SCOPUS:85086299173
SN - 2044-6055
VL - 10
SP - e035258
JO - BMJ Open
JF - BMJ Open
IS - 6
ER -