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

JOURNAL TITLE: Donald School Journal of Ultrasound in Obstetrics and Gynecology

1. GiGi Selvan
2. Dorota Bomba Opon
3. Sertac Esin
4. Sonal Panchal
5. Suada Tinjić
6. Raul Moreira Neto
7. Selma Porovic
8. Aida Salihagic Kadic
9. Asim Kurjak
Publishing Year
Author Affiliations
    1. Department of Obstetrics and Gynecology, Medical School University of Zagreb, Zagreb, Croatia; University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
    1. Clinical Ultrasound and Fetal Medicine Unit – Ecomoinhos, Porto Alegre, Brazil
    1. Private Gynaecological Clinic, Korak do života, Tuzla, Bosnia and Herzegovina
    1. Rainbow Hospitals, Agra, Uttar Pradesh, India
    2. Dubrovnik International University, Dubrovnik, Croatia;
    3. Dr Nagori’s Institute for Infertility and IVF; Centre of Excellence for Ian, Donald School Inter-university of Medical, Ultrasound, Ahmedabad, Gujarat, India
    1. Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
    1. Annai Velankanni Multispeciality Hospital, Tirunelveli, Tamil Nadu, India
    1. Başkent University School of Medicine, Ankara, Turkey
    2. Baskent University, Perinatal Medicine Center, Ankara, Turkey
    3. Başkent University Medical Faculty, Ankara, Turkey
    1. Department of Physiology, Medical School, University of Zagreb, Zagreb, Croatia
    1. Public Health Center of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina
    2. Public Health Center of the Sarajevo Canton, Sarajevo, Bosnia and Herzegovina
  • Article keywords


    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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