Department of Rehabilitation, Physiotherapy and Balneotherapy, Faculty of Health Sciences, Medical University, Lublin, Poland.
Department of Children Orthopedics, Medical University, Lublin, Poland.
Ann Agric Environ Med. 2021 Mar 18;28(1):183-188. doi: 10.26444/aaem/126746. Epub 2020 Sep 11.
Premature babies are a special group at risk of persistent brain damage caused by diseases, the most serious of which are cerebral palsy(CP), autism spectrum disorders (ASD) and mental retardation, among others. These conditions may occur concurrently, but appear more often as separate disease syndromes in the same group of at-risk children. Long-term observation of psychomotor development by an interdisciplinary medical team closely cooperating with parents is necessary. It is important to detect the risk of developing these diseases as soon as possible in all development spheres.
The research was conducted to demonstrate the prognostic value of 'red flags' of developmental milestones and the ability to detect early signs of risk of developing CP and ASD in extremely premature babies. In this preliminary study, 42 preterm babies, born after less than 32 weeks pregnancy participated.
The occurrence of 'red flags'in the spheres: gross motor, fine motor and cognitive at 9 months was strongly associated with their presence at 24 months. The sensitivity and specificity were: gross motor - 0.91 (95% CI: 0.59, 1.00) and 0.94 (95% CI: 0.79, 0.99); fine motor - 0.83 (95% CI 0.36-1.00) and 1.00 (95% CI: 0.90-1.00); cognitive - 1.00 (0.40, 1.00) and 0.97 (0.86, 1.00). Other spheres had lower sensitivity but high specificity.
The conclusion is that the 'red flags'at the 9 months milestones already predict the normal or developmental delay of premature babies, and predict the risk of CP and ASD. Due to the availability and lack of the need for specialized and costly training, it is worth considering their use in everyday life medical practice.
早产儿是一群特殊的群体,容易因疾病而导致持续性脑损伤,其中最严重的是脑瘫(CP)、自闭症谱系障碍(ASD)和智力障碍等。这些疾病可能同时发生,但在同一高危儿童群体中更常见的是作为单独的疾病综合征出现。需要由一个多学科医疗团队与家长密切合作,对精神运动发育进行长期观察。在所有发展领域尽早发现这些疾病的风险非常重要。
本研究旨在展示发育里程碑“红色警报”的预后价值,并检测极低出生体重早产儿 CP 和 ASD 发病风险的早期迹象。在这项初步研究中,有 42 名胎龄不足 32 周的早产儿参与。
9 个月时粗大运动、精细运动和认知领域的“红色警报”的出现与 24 个月时的存在有很强的相关性。敏感性和特异性分别为:粗大运动-0.91(95%CI:0.59,1.00)和 0.94(95%CI:0.79,0.99);精细运动-0.83(95%CI 0.36-1.00)和 1.00(95%CI:0.90-1.00);认知-1.00(0.40,1.00)和 0.97(0.86,1.00)。其他领域的敏感性较低,但特异性较高。
9 个月大的婴儿出现“红色警报”,这已经预示着早产儿的正常或发育迟缓,以及 CP 和 ASD 的发病风险。由于其可用性和不需要专门的、昂贵的培训,因此值得考虑在日常医疗实践中使用。