从 3 个月到 5 岁接受低温治疗的围产期窒息儿童的个体纵向神经发育轨迹。
Individual longitudinal neurodevelopmental trajectories of children treated with hypothermia for perinatal asphyxia from 3 months to 5 years of age.
机构信息
HAN University of Applied Sciences, Department of Allied Health Studies, PO Box 6960, 6503 GL, Nijmegen, the Netherlands; Radboud University Medical Center, Amalia Children's Hospital, Radboud Institute for Health Sciences, Department of Rehabilitation, Pediatric Physical Therapy.
Radboud University Medical Center, Amalia Children's Hospital, Radboud Institute for Health Sciences, Department of Rehabilitation, Pediatric Physical Therapy.
出版信息
Res Dev Disabil. 2020 Jul;102:103659. doi: 10.1016/j.ridd.2020.103659. Epub 2020 May 18.
BACKGROUND
Hypothermia for perinatal asphyxia is a common treatment to decrease morbidity. This study aims to describe a) individual longitudinal neurodevelopmental trajectories over 5 years in children with perinatal asphyxia treated with hypothermia and b) the correlation between movement quality at 3 months and motor developmental outcomes at 5 years of age.
METHODS
In this longitudinal cohort study, 18 children (12 male) were assessed at 3 (t), 6 (t), 12 (t), and 24 (t) months, and at the age of 5 (t) years, with standardized norm-referenced tests.
RESULTS
Six children showed abnormal movement quality assessed with General Movements (t) and all showed severe neurodevelopmental disabilities at t. The 12 children without severe disabilities, showed a significant normalization of z-scores over the five assessment points (linear mixed model analysis). At t, four of these children scored mildly delayed motor or cognitive development.
CONCLUSION AND IMPLICATIONS
Children without anomalies on the MRI before hospital discharge and normal movement quality at 3 months of age showed normal neurodevelopment at the age of 5, however, individual motor trajectories showed variability over time. Presents of abnormal GMs tend to detect CP and developmental problems, advocating a developmental surveillance to determine need for early intervention.
背景
围产期窒息的低温治疗是降低发病率的常用方法。本研究旨在描述：a）接受低温治疗的围产期窒息儿童的个体纵向神经发育轨迹，随访时间长达 5 年；b）3 个月时的运动质量与 5 岁时运动发育结局的相关性。
方法
在这项纵向队列研究中，18 名儿童（男 12 名）分别在 3 个月（t）、6 个月（t）、12 个月（t）和 24 个月（t）以及 5 岁（t）时接受评估，使用标准化的常模参照测试。
结果
6 名儿童的运动质量评估（GMs）异常，所有儿童在 t 时均表现出严重的神经发育障碍。12 名无严重残疾的儿童在五个评估点上的 z 评分显著正常化（线性混合模型分析）。在 t 时，其中 4 名儿童的运动或认知发育轻度延迟。
结论和意义
在出院前 MRI 无异常且 3 个月时运动质量正常的儿童，在 5 岁时神经发育正常，但个体的运动轨迹随时间变化而存在差异。异常 GMs 的出现可能预示着 CP 和发育问题，因此需要进行发育监测以确定是否需要早期干预。
Zotero 插件