Crowle Cathryn, Walker Karen, Galea Claire, Novak Iona, Badawi Nadia
Grace Centre for Newborn Care, The Children's Hospital Westmead, Sydney, Australia; University of Sydney, Sydney, Australia.
Grace Centre for Newborn Care, The Children's Hospital Westmead, Sydney, Australia; University of Sydney, Sydney, Australia; Cerebral Palsy Alliance Research Institute, Sydney, Australia.
Early Hum Dev. 2017 Aug;111:42-48. doi: 10.1016/j.earlhumdev.2017.05.010. Epub 2017 May 31.
Neonates who undergo major surgery are at risk of neurodevelopmental disability. The General Movements Assessment (GMA) is a valid and reliable method to predict neurodevelopment, however, there are minimal data on the applicability among infants post-surgery.
To describe GMs trajectories following neonatal surgery.
Prospective cohort study.
217 infants following major cardiac and non-cardiac neonatal surgery.
Infants were assessed following surgery at term age (mean 40weeks, SD 2.3), and at 3months of age (mean 12weeks, SD 1.6) using the GMA and the Bayley Scales of Infant and Toddler Development III. GMA videos were independently scored by three advanced trained assessors, two blinded to infant details.
The most common result in the writhing period was 'poor repertoire' (n=117, 54%), however, 99 (84%) of these infants had normal fidgety movements. For infants with normal writhing (n=75, 34%), only four had absent fidgety movements. Cramped synchronised movements were seen in 10 infants, and three of these were rated as absent fidgety. There was no significant difference between the surgical groups. In total, 24 infants (11%) had absent fidgety movements and lower scores on average in all subtests of the BSID-III than those with normal fidgety movements.
This is the first report describing GMs trajectories in infants who have undergone neonatal surgery. Similar to other high risk infant populations, this group showed a high proportion of poor repertoire writhing movements, however, most infants demonstrated normal fidgety movements and development at 3months of age.
接受大手术的新生儿有神经发育障碍的风险。全身运动评估（GMA）是预测神经发育的一种有效且可靠的方法，然而，关于其在术后婴儿中的适用性数据极少。
描述新生儿手术后的全身运动轨迹。
前瞻性队列研究。
217例接受心脏及非心脏大手术的新生儿。
在足月年龄（平均40周，标准差2.3）及3月龄（平均12周，标准差1.6）时，使用GMA和贝利婴幼儿发展量表第三版对婴儿进行评估。GMA视频由三名经过高级培训的评估人员独立评分，其中两名对婴儿详细信息不知情。
扭动期最常见的结果是“动作 repertoire 差”（n = 117，54%），然而，这些婴儿中有99例（84%）的不安运动正常。对于扭动正常的婴儿（n = 75，34%），只有4例不安运动缺失。10例婴儿出现痉挛同步运动，其中3例被评为不安运动缺失。手术组之间无显著差异。总共有24例婴儿（11%）不安运动缺失，并且在贝利婴幼儿发展量表第三版的所有子测试中的平均得分低于不安运动正常的婴儿。
这是第一份描述接受新生儿手术婴儿全身运动轨迹的报告。与其他高危婴儿群体相似，该组中动作 repertoire 差的扭动运动比例较高，然而，大多数婴儿在3月龄时不安运动和发育正常。
