Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 14 , ISSUE 4 ( October-December, 2020 ) > List of Articles

Original Scientific Paper

A Critical Appraisal of Kurjak Antenatal Neurodevelopmental Test: Five Years of Wide Clinical Use

Asim Kurjak, Milan Stanojevic, Lara Spalldi Barisic, Panos Antsaklis, Raul Moreira Neto, Suada Tinjić, Sonal Panchal, Dorota Bomba Opon, GiGi Selvan, Sertac Esin, Edin Medjedović, Aida Salihagic Kadic, Selma Porovic, Miro Jakovljević

Keywords : Development, Fetal behavior, Fetal neurology, Four-dimensional ultrasound, General movements,Cerebral palsy

Citation Information : Kurjak A, Stanojevic M, Barisic LS, Antsaklis P, Neto RM, Tinjić S, Panchal S, Opon DB, Selvan G, Esin S, Medjedović E, Kadic AS, Porovic S, Jakovljević M. A Critical Appraisal of Kurjak Antenatal Neurodevelopmental Test: Five Years of Wide Clinical Use. Donald School J Ultrasound Obstet Gynecol 2020; 14 (4):304-310.

DOI: 10.5005/jp-journals-10009-1669

License: CC BY-NC 4.0

Published Online: 13-01-2021

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Purpose: To evaluate the results of the Kurjak antenatal neurodevelopmental test (KANET) in multicentric studies. Materials and methods: In KANET, normal, borderline, and abnormal fetuses postnatal development was followed. The Chi-square was considered significant if p < 0.05 was used in the statistical analysis. Specificity, sensitivity, prevalence, positive and negative predictive value, false-positive, and false-negative results were calculated. Results: In 3,709 singleton fetuses, KANET was assessed. Postnatal follow-up was available for 1,556 of 1,573 (42.4%) infants. For 2,136, the data were not available. Interrater reliability (κ coefficient) for low-risk fetuses was between 0.64 and 0.65 (agreement 94.2–97.3%), for high-risk fetuses was between 0.44 and 0.53 (agreement 70.5–78.9%), respectively. Borderline KANET was found in 153 (9.7%), abnormal in 52 (3.3%), both more prevalent in high-risk pregnancies (χ2 = 457.36; df = 2; p < 0.01). Abnormal KANET was connected with severe postnatal developmental delay (χ2 = 315.28; df = 6; p < 0.01). In 47 out of 1,102 children aged 2 years and more, abnormal KANET was found, among them in one with CP. In 1 out of 1,055 children with normal KANET, severe developmental delay was found. The KANET has low sensitivity for detection of developmental delay and CP. The KANET specificity is high for all tested variables, positive predictive value and the false-positive rate are high, the negative predictive value is high (99.77–99.95%), and the false-negative rate is low (0.23–0.05%). Conclusion: With normal KANET, there is a high probability of normal infant development. If the KANET score is borderline or abnormal in high-risk pregnancies, postnatal development may appear abnormal.


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