Child Development Centre, University Children's Hospital Zurich, Zurich, Switzerland; Department of Neonatology, University Hospital Zurich, Zurich, Switzerland.
Acta Paediatr. 2013 Aug;102(8):809-14. doi: 10.1111/apa.12271. Epub 2013 May 8.
To assess patterns of change for different neuromotor functions in very low birth weight (VLBW) children during school age and to identify factors associated with improvement.
In a longitudinal study, we examined 65 prospectively enrolled VLBW children (38 female, 59%) without cerebral palsy at age six and 10 years. Measures included the evaluation of timed motor performance and motor overflow (MO) for the motor components of the Zurich Neuromotor Assessment (pure motor-, adaptive fine- and gross motor tasks, static balance) and a standardized neurological examination. Variables associated with improvement were assessed by multiple regression analyses.
Between six and 10 years, adaptive fine motor tasks (40% vs. 17% of children scoring below 10th percentile) and MO (77% vs. 55%) improved significantly (both p<0.01), while all other components remained stable (pure motor 23% vs. 25%, adaptive gross motor 26% vs. 34%, static balance 18% vs. 20%, respectively). Mild neurological abnormalities at 6 years of age were associated with less improvement.
Neuromotor functions improve in some children potentially reflecting catch up of maturational delay. However, the majority of neuromotor functions remain abnormal in a significant proportion of VLBW children.
评估极低出生体重（VLBW）儿童在学龄期不同神经运动功能的变化模式，并确定与改善相关的因素。
在一项纵向研究中，我们检查了 65 名在 6 岁和 10 岁时没有脑瘫的前瞻性纳入的 VLBW 儿童（38 名女性，59%）。评估指标包括苏黎世神经运动评估（纯运动、适应性精细运动和粗大运动任务、静态平衡）的运动成分的计时运动表现和运动溢出（MO），以及标准化神经检查。通过多元回归分析评估与改善相关的变量。
在 6 岁到 10 岁之间，适应性精细运动任务（40%的儿童评分低于第 10 百分位，而 17%的儿童评分低于第 10 百分位）和 MO（77%的儿童评分低于第 10 百分位，而 55%的儿童评分低于第 10 百分位）显著改善（均 p<0.01），而所有其他成分保持稳定（纯运动 23%，适应性粗大运动 26%，静态平衡 18%，分别为 25%、34%、20%）。6 岁时轻度神经异常与改善较少相关。
一些儿童的神经运动功能有所改善，可能反映了成熟延迟的追赶。然而，在很大一部分 VLBW 儿童中，大多数神经运动功能仍然异常。
