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早产儿在矫正胎龄足月时的自发性运动的特定特征与 3 岁时的发育迟缓有关。

Specific characteristics of spontaneous movements in preterm infants at term age are associated with developmental delays at age 3 years.

机构信息

Graduate School of Education, University of Tokyo, Tokyo, Japan.

出版信息

Dev Med Child Neurol. 2013 Aug;55(8):713-21. doi: 10.1111/dmcn.12156. Epub 2013 Apr 19.

Abstract

AIM

The aim of this study was to investigate the relationship between the characteristics of spontaneous movements in preterm infants at term age and developmental delay at 3 years of age.

METHOD

We analysed video recordings of the spontaneous movements in the supine position of 124 preterm infants (44 males, 80 females) at 36 to 44 weeks postmenstrual age (PMA). The infants were born preterm (22-36wks PMA; birthweight 489-1696g) and had not received a diagnosis of a neurological or developmental disorder by the age of 3 years. The recorded spontaneous movements were quantified using six movement indices, which were calculated from two-dimensional trajectories of all limbs. The infants were divided into three developmental groups, normal, borderline, or delayed, based on their developmental quotient as calculated using the Kyoto Scale of Psychological Development 2001 (Kyoto Scale) at 3 years of age. Group differences in the movement indices were analysed.

RESULTS

In the delayed group, average velocity of arms and legs were significantly lower (p<0.05 and p<0.01 respectively), the numbers of movement units of arms and legs were significantly lower (p<0.05 and p<0.01 respectively), kurtosis of acceleration of arms and legs was significantly higher (p<0.05 in each case), and correlation between limb velocities was higher (p<0.05) than in the normal group.

INTERPRETATION

In children who exhibited developmental delay at 3 years of age, the spontaneous movements at term age can be described as less active with intermittent occurrences of abrupt and synchronized movements of the limbs. Recognition of these characteristics of spontaneous movements at term age may be used as a predictor for subsequent cognitive and behavioural development in preterm infants.

摘要

目的

本研究旨在探讨早产儿在足月时的自发性运动特征与 3 岁时发育迟缓之间的关系。

方法

我们分析了 124 例早产儿(男 44 例,女 80 例)在孕龄 36 至 44 周时仰卧位自发性运动的视频记录。这些婴儿早产(孕龄 22-36 周;出生体重 489-1696g),3 岁时未被诊断为神经或发育障碍。记录的自发性运动使用六个运动指标进行量化,这些指标是通过所有肢体的二维轨迹计算得出的。根据 3 岁时使用京都心理发育量表 2001 版(京都量表)计算的发育商,将婴儿分为正常、边缘或延迟三个发育组。分析了运动指标在组间的差异。

结果

在延迟组中,手臂和腿部的平均速度明显较低(分别为 p<0.05 和 p<0.01),手臂和腿部的运动单位数量明显较少(分别为 p<0.05 和 p<0.01),手臂和腿部的加速度峰度明显较高(分别为 p<0.05),四肢速度之间的相关性也较高(p<0.05)。

结论

在 3 岁时表现出发育迟缓的儿童中,足月时的自发性运动可以描述为活动较少,四肢会突然出现间歇性、同步运动。识别这些足月时自发性运动的特征可能被用作预测早产儿后续认知和行为发展的指标。

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