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极早产儿与足月出生对照婴儿的运动和姿势。

Movements and posture in infants born extremely preterm in comparison to term-born controls.

机构信息

Neonatal Research Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.

Research Unit Interdisciplinary Developmental Neuroscience, Dept. Phoniatrics, Medical University of Graz, Austria.

出版信息

Early Hum Dev. 2021 Mar;154:105304. doi: 10.1016/j.earlhumdev.2020.105304. Epub 2020 Dec 26.

Abstract

BACKGROUND

Identifying altered motor development at an early stage is crucial for infants born extremely preterm (EPT), as they face a high risk of long-term neurodevelopmental impairment. The Prechtl General Movement Assessment (GMA), including the Motor Optimality Score Revised (MOS-R), can provide important insights into these infants' later neurodevelopmental function.

AIMS

To compare age-specific movements and postures in infants born EPT compared to term-born controls at three months corrected age.

STUDY DESIGN

A retrospective observational study design.

SUBJECTS

53 infants born EPT (mean gestational age 25 weeks; 23-26) were included and matched for gender and recording age with 53 term-born controls (mean gestational age 40 weeks, 37-41).

OUTCOME MEASURES

GMA including the MOS-R at three months corrected age (re-analysis of video-recordings).

RESULTS

Of the infants born EPT, 19% showed aberrant fidgety movements (FMs); all term-born infants had normal FMs. There was a significant difference in MOS-R (p≤0.001) between controls (median = 26, IQR 26-28) and EPT infants (median = 18, IQR 17-21), as well as in all subcategories of the MOS-R. The EPT group had a significantly higher number of infants showing atypical movement and postural patterns as well as a reduced repertoire for the age compared to the controls. All infants born EPT moved monotonously and jerky. P-values were all <0.001.

CONCLUSION

Infants born EPT have an altered early motor development. The MOS-R may contribute to further understanding of motor performance in this group of children since it can detect neurological- and motor alterations at a very early age.

摘要

背景

对于极早产儿(EPT)来说,早期识别运动发育异常至关重要,因为他们面临着长期神经发育障碍的高风险。Prechtl 一般性运动评估(GMA),包括运动优化评分修订版(MOS-R),可以为这些婴儿的后期神经发育功能提供重要的见解。

目的

比较出生时极早产儿(EPT)与足月出生对照组婴儿在矫正 3 个月龄时的特定年龄运动和姿势。

研究设计

回顾性观察性研究设计。

受试者

纳入 53 名 EPT 出生婴儿(平均胎龄 25 周;23-26),并按性别和记录年龄与 53 名足月出生对照组婴儿(平均胎龄 40 周;37-41)相匹配。

观察指标

包括矫正 3 个月龄时的 GMA 和 MOS-R(视频记录的重新分析)。

结果

在 EPT 出生的婴儿中,19%出现异常烦躁运动(FM);所有足月出生的婴儿均有正常 FM。对照组(中位数=26,IQR 26-28)和 EPT 婴儿(中位数=18,IQR 17-21)之间的 MOS-R 存在显著差异(p≤0.001),以及 MOS-R 的所有亚类。与对照组相比,EPT 组显示出更多婴儿具有非典型运动和姿势模式,并且年龄的运动模式范围缩小。所有 EPT 出生的婴儿运动单调且急促。所有 P 值均<0.001。

结论

EPT 出生的婴儿运动发育异常。MOS-R 可能有助于进一步了解这组儿童的运动表现,因为它可以在非常早期检测到神经和运动异常。

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