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早产神经发育评估在矫正年龄3个月和实际年龄2岁时的预测效度

Predictive Validity of the Premie-Neuro at 3 Months' Adjusted Age and 2 Years' Chronological Age.

作者信息

Gagnon Kendra, Cannon Susan, Weatherstone Kathleen B

机构信息

Department of Physical Therapy Education, Rockhurst University, Kansas City, Missouri (Dr Gagnon); Center for Child Health and Development, University of Kansas Medical Center, Kansas City (Dr Cannon); and Neonatal Intensive Care Services, Sunflower Neonatology Associates, Overland Park Regional Medical Center, Overland Park, Kansas (Dr Weatherstone).

出版信息

Adv Neonatal Care. 2016 Apr;16(2):151-7. doi: 10.1097/ANC.0000000000000248.

Abstract

BACKGROUND

It is difficult to predict which preterm babies are most at risk for poor neurodevelopmental outcomes. A quick, highly predictive assessment tool would aid neonatal clinicians in making decisions about follow-up care.

PURPOSE

The purpose of this study was to determine whether performance on the Premie-Neuro in the neonatal intensive care unit predicted neurodevelopmental outcomes at 3 months' adjusted age and 24 months' chronological age.

METHODS

Thirty-four preterm infants were administered the Premie-Neuro in the neonatal intensive care unit. Infants were assessed using the Infanib and Alberta Infant Motor Scales at 3 months' adjusted age, and using the Bayley Scales of Infant and Toddler Development, Third edition (Bayley-III) at 24 months' chronological age. Scores were analyzed to determine whether Premie-Neuro performance at less than 37 weeks postmenstrual age was predictive of neurodevelopmental outcomes at 3 months' adjusted age and 24 months' chronological age.

RESULTS

Premie-Neuro raw scores were predictive of outcomes at 3 months' adjusted age and 24 months' chronological age. Premie-Neuro classifications were not predictive of Infanib and Alberta Infant Motor Scale classifications at 3 months' adjusted age but were predictive of Bayley-III classification at 24 months' chronological age.

IMPLICATIONS FOR PRACTICE

Premie-Neuro raw scores may be used by the clinician to identify infants at risk for neurodevelopmental delays. Premie-Neuro classifications should be interpreted cautiously.

IMPLICATIONS FOR RESEARCH

More research is needed to determine whether the Premie-Neuro may be used as an adjunct to clinical assessment to identify infants who are most at risk for developmental delay.

摘要

背景

很难预测哪些早产婴儿发生神经发育不良结局的风险最高。一种快速、具有高度预测性的评估工具将有助于新生儿临床医生做出后续护理决策。

目的

本研究的目的是确定新生儿重症监护病房中早产儿神经发育评估量表(Premie-Neuro)的表现是否能预测矫正年龄3个月和实际年龄24个月时的神经发育结局。

方法

34名早产儿在新生儿重症监护病房接受了早产儿神经发育评估量表测试。在矫正年龄3个月时,使用婴儿神经功能国际分类法(Infanib)和艾伯塔婴儿运动量表对婴儿进行评估;在实际年龄24个月时,使用贝利婴幼儿发展量表第三版(Bayley-III)进行评估。对分数进行分析,以确定孕龄小于37周时早产儿神经发育评估量表的表现是否能预测矫正年龄3个月和实际年龄24个月时的神经发育结局。

结果

早产儿神经发育评估量表的原始分数可预测矫正年龄3个月和实际年龄24个月时的结局。早产儿神经发育评估量表的分类在矫正年龄3个月时不能预测婴儿神经功能国际分类法和艾伯塔婴儿运动量表的分类,但在实际年龄24个月时可预测贝利婴幼儿发展量表第三版的分类。

对实践的启示

临床医生可使用早产儿神经发育评估量表的原始分数来识别有神经发育延迟风险的婴儿。对早产儿神经发育评估量表的分类应谨慎解读。

对研究的启示

需要更多研究来确定早产儿神经发育评估量表是否可作为临床评估的辅助手段,以识别发育延迟风险最高的婴儿。

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