Salavati Sahar, Bos Arend F, Doyle Lex W, Anderson Peter J, Spittle Alicia J
Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Pediatrics. 2021 Sep;148(3). doi: 10.1542/peds.2020-049572.
Children born very preterm (<32 weeks' gestation) have more neurodevelopmental problems compared with term-born peers. Aberrant fidgety movements (FMs) are associated with adverse motor outcomes in children born very preterm. However, associations of aberrant FMs combined with additional movements and postures to give a motor optimality score-revised (MOS-R) with school-aged cognitive and motor outcomes are unclear. Our aim with this study was to determine those associations.
Of 118 infants born <30 weeks' gestation recruited into a randomized controlled trial of early intervention, 97 had a general movements assessment at 3 months' corrected age and were eligible for this study. Early motor repertoire including FMs and MOS-R were scored from videos of infant's spontaneous movement at 3 months' corrected age. At 8 years' corrected age, cognitive and motor performances were evaluated. Associations of early FMs and MOS-R with outcomes at 8 years were determined using linear regression.
Seventy-eight (80%) infants with early motor repertoire data had neurodevelopmental assessments at 8 years. A higher MOS-R, and favorable components of the individual subscales of the MOS-R, including the presence of normal FMs, were associated with better performance for general cognition, attention, working memory, executive function and motor function at 8 years; eg, presence of normal FMs was associated with a 21.6 points higher general conceptual ability score (95% confidence interval: 12.8-30.5; < .001) compared with absent FMs.
Favorable early motor repertoire of infants born <30 weeks is strongly associated with improved cognitive and motor performance at 8 years.
与足月儿相比，极早产儿（妊娠<32周）有更多的神经发育问题。异常的不安运动（FMs）与极早产儿的不良运动结局相关。然而，异常FMs与其他运动和姿势相结合以得出修订后的运动最优性评分（MOS-R）与学龄期认知和运动结局之间的关联尚不清楚。本研究的目的是确定这些关联。
在纳入一项早期干预随机对照试验的118例妊娠<30周出生的婴儿中，97例在矫正年龄3个月时进行了一般运动评估并符合本研究条件。根据矫正年龄3个月时婴儿自发运动的视频对包括FMs和MOS-R在内的早期运动技能进行评分。在矫正年龄8岁时，评估认知和运动表现。使用线性回归确定早期FMs和MOS-R与8岁时结局的关联。
78例（80%）有早期运动技能数据的婴儿在8岁时进行了神经发育评估。较高的MOS-R以及MOS-R各个子量表的有利成分，包括正常FMs的存在，与8岁时一般认知、注意力、工作记忆、执行功能和运动功能的更好表现相关；例如，与无正常FMs相比，有正常FMs与一般概念能力得分高21.6分相关（95%置信区间：12.8 - 30.5；P <.001）。
妊娠<30周出生婴儿良好的早期运动技能与8岁时认知和运动表现的改善密切相关。
