Validation of a clinical scale to assess abdominal status of preterm infants.

BACKGROUND: Prematurity implies an immature digestive system, with a risk of serious digestive complications. An instrument to assess the abdominal status of preterm infants is necessary. AIM: To develop and validate a scale (ECAP scale: Evaluation Clinique de l'état Abdominal du Prématuré) to objectively assess the abdominal status of preterm infant. METHODS: In a prospective monocentric study, newborns between 24 and 37 weeks of gestational age were assessed by ECAP scale. It was created by a multidisciplinary team and is based on the clinical examination of the newborns and contains 10 items, each rated from 0 to 2. The following psychometrics properties were studied: acceptability and content validity (CVI), internal consistency (Cronbach's α), inter-rater reliability (intraclass correlation coefficients ICC), internal structure validity (inter-item Spearman correlation) and external structure validity (clinical data). RESULTS: From April to July 2023, a total of 120 newborns were included and 1935 evaluations with ECAP scale were performed. Acceptability and content validity were good with full data completed and CVI of 0.83 [0.49; 1]. Cronbach's alpha coefficient was 0.73. Test-retest reliability was excellent with an overall ICC of 0.97 [0.962; 0.971]. Internal and external structures were validated and sensitivity to change was significant. CONCLUSION: This study proposes the first scale to assess the abdominal status of preterm infants, which is validated, reliable, as well as being quick and easy to use by the multidisciplinary team caring for preterms. This could be used to evaluate and monitor abdominal status of preterms, allowing rapid detection of digestive degradation.