Barnett A L, Guzzetta A, Mercuri E, Henderson S E, Haataja L, Cowan F, Dubowitz L
Department of Paediatrics, Imperial College School of Medicine, Hammersmith Campus, London, UK.
Arch Dis Child. 2004 Jul;89(7):637-43. doi: 10.1136/adc.2002.019349.
To examine the predictive value of early developmental testing for identifying neuromotor and perceptual-motor impairment at school age in children with neonatal encephalopathy (NE).
Eighty full term infants with NE were followed longitudinally. Where possible, children were tested on the Griffiths scales at 1 and 2 years and at 5-6 years, on the Touwen Examination, Movement ABC, and WPPSI. The relation between the Griffiths scores and later outcome measures was examined using correlation coefficients and sensitivity and specificity values.
By 2 years, 25 children with cerebral palsy were too severely impaired to be formally assessed and remained so at 5-6 years. Abnormal Griffiths scores were obtained by 12% and 7% of the children at 1 and 2 years respectively. At 5-6 years, 33% had poor Movement ABC scores and 15% poor WPPSI scores. The highest correlation between Griffiths scores and the outcome measures was for the Movement ABC (0.72), although this accounted for only 50% of the variance. Sensitivity scores for the Movement ABC were below 70% but specificity was 100%.
A poor score on the Griffiths scales at 1 and/or 2 years is a good predictor of impairment at school age. However, a normal score in the early years cannot preclude later neurological, perceptual-motor, or cognitive abnormalities.
探讨早期发育测试对识别新生儿脑病（NE）患儿学龄期神经运动和感知运动障碍的预测价值。
对80例足月NE患儿进行纵向随访。尽可能在1岁、2岁以及5至6岁时对患儿进行格里菲斯量表测试、陶文检查、运动ABC测试和韦氏学前及初小儿童智力测验（WPPSI）。使用相关系数以及敏感度和特异度值来检验格里菲斯量表得分与后期结果指标之间的关系。
到2岁时，25例脑瘫患儿受损严重，无法进行正式评估，在5至6岁时依然如此。1岁和2岁时分别有12%和7%的患儿格里菲斯量表得分异常。在5至6岁时，33%的患儿运动ABC测试得分较差，15%的患儿WPPSI测试得分较差。格里菲斯量表得分与结果指标之间的最高相关性出现在运动ABC测试中（0.72），不过这仅占方差的50%。运动ABC测试的敏感度得分低于70%，但特异度为100%。
1岁和/或2岁时格里菲斯量表得分较低是学龄期功能受损的良好预测指标。然而，早期得分正常并不能排除后期出现神经、感知运动或认知异常的可能性。
