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生命前四个月的自发运动:对中度和晚期早产儿的加速度计研究

Spontaneous movements in the first four months of life: An accelerometric study in moderate and late preterm infants.

作者信息

Bultmann Carla-Sophie, Orlikowsky Thorsten, Häusler Martin, Trepels-Kottek Sonja, Disselhorst-Klug Catherine, Schoberer Mark

机构信息

Department of Rehabilitation and Prevention Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, Pauwelsstraße 20, 52074 Aachen, Germany.

Division of Neonatology, Department of Pediatric and Adolescent Medicine, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.

出版信息

Early Hum Dev. 2019 Mar;130:1-9. doi: 10.1016/j.earlhumdev.2019.01.002. Epub 2019 Jan 11.

Abstract

BACKGROUND

Moderate preterm infants (MPI) and late preterm infants (LPI) account for the majority of children born preterm. Up to 5% of MPI and LPI are estimated to manifest neurodevelopmental impairments. However, information about normal early motor development in these patients is lacking.

AIM

To find characteristic patterns for motor development in the first four months of life among MPI and LPI without risk factors for developmental impairment by using accelerometry of spontaneous movements.

STUDY DESIGN

Prospective and observational study.

SUBJECTS

Twenty-three MPI and LPI (9 female, 14 male) without known risk factors for neurodevelopmental impairment were included in this study. Spontaneous movements were measured by accelerometry at the time of hospital discharge (mean: 36.6wks postmenstrual age (PMA)) and at the corrected age of three months (mean: 53.0wks PMA).

OUTCOME MEASURES

Motor development was described by analyzing 36 parameters calculated from the acceleration signal. Normal neurodevelopmental outcome was confirmed by Bayley Scales of Infant Development at the corrected age of two years.

RESULTS

Statistically significant differences (p < 0.05) between the two measurements could be shown in 26 out of the 36 parameters. Striking changes in motor development were an increase in acceleration and variability of the spontaneous movements, the main criterion for analyzing spontaneous movements. Furthermore, the regularity of spontaneous movements increased significantly.

CONCLUSION

Characteristic patterns of normal motor development in MPI and LPI can be identified and provide a basis for future investigations aiming at the early detection of abnormal motor development for this specific patient group.

摘要

背景

中度早产儿(MPI)和晚期早产儿(LPI)占早产出生儿童的大多数。估计高达5%的MPI和LPI会出现神经发育障碍。然而,缺乏关于这些患者正常早期运动发育的信息。

目的

通过使用自发运动加速度测量法,找出无发育障碍风险因素的MPI和LPI在出生后前四个月的运动发育特征模式。

研究设计

前瞻性观察研究。

研究对象

本研究纳入了23名无已知神经发育障碍风险因素的MPI和LPI(9名女性,14名男性)。在出院时(平均:月经后年龄(PMA)36.6周)和矫正年龄三个月时(平均:PMA 53.0周)通过加速度测量法测量自发运动。

观察指标

通过分析从加速度信号计算出的36个参数来描述运动发育。在矫正年龄两岁时通过贝利婴儿发育量表确认正常神经发育结果。

结果

36个参数中的26个在两次测量之间显示出统计学上的显著差异(p<0.05)。运动发育的显著变化是自发运动的加速度和变异性增加,这是分析自发运动的主要标准。此外,自发运动的规律性显著增加。

结论

可以识别出MPI和LPI正常运动发育的特征模式,并为未来旨在早期检测该特定患者群体异常运动发育的研究提供基础。

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