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中重度支气管肺发育不良婴儿的早期运动发育。

Early motor development in infants with moderate or severe bronchopulmonary dysplasia.

机构信息

Children's Hospital of Philadelphia, Philadelphia, PA, USA.

University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

出版信息

J Neonatal Perinatal Med. 2022;15(1):55-62. doi: 10.3233/NPM-210750.

Abstract

BACKGROUND

Timely development of early motor skills is essential for later skill development in multiple domains. Infants with severe bronchopulmonary dysplasia (BPD) have significant risk for developmental delays. Early motor skill development in this population has not been described. The aim of the present study was to characterize motor skill acquisition at 3 and 6 months corrected age (CA) and assess trajectories of skill development over this time period in infants with severe BPD.

METHODS

We performed a single-center, retrospective descriptive study. Motor skills were categorized as present and normal, present but atypical, or absent at 3 and 6 months CA. Logistic regression was used to identify clinical characteristics associated with negative trajectories of skill acquisition.

RESULTS

Data were available for 232 infants and 187 infants at 3 and 6 months CA, respectively. Ten motor skills were present and normal in 5-44%(range) of subjects at 3 months. Nineteen motor skills were present and normal in 1-63%(range) of subjects at 6 months. Significant postural asymmetry was noted throughout the study period. Loss of skills and worsening asymmetries over time were common. Exposure to sedating medications was significantly associated with poor development.

CONCLUSION

We report delays in motor skill acquisition and postural asymmetries in infants with severe BPD at both 3 and 6 months CA. The association between sedating medications and poor development suggests that efforts to limit these exposures may lead to improved development. Targeted interventions to facilitate early motor development may improve outcomes of this high-risk population.

摘要

背景

早期运动技能的及时发展对于多个领域的后期技能发展至关重要。患有严重支气管肺发育不良(BPD)的婴儿有发育迟缓的显著风险。该人群的早期运动技能发展尚未描述。本研究的目的是描述严重 BPD 婴儿在 3 个月和 6 个月校正年龄(CA)的运动技能获得情况,并评估在此期间技能发展的轨迹。

方法

我们进行了一项单中心回顾性描述性研究。将运动技能分为存在且正常、存在但异常或不存在 3 个月和 6 个月 CA。逻辑回归用于确定与技能获得负向轨迹相关的临床特征。

结果

分别有 232 名和 187 名婴儿在 3 个月和 6 个月 CA 时获得了数据。在 3 个月时,有 5-44%(范围)的受试者存在 10 种运动技能且正常。在 6 个月时,有 1-63%(范围)的受试者存在 19 种运动技能且正常。整个研究期间都存在显著的姿势不对称。随着时间的推移,技能丧失和不对称性恶化很常见。镇静药物的暴露与发育不良显著相关。

结论

我们报告了严重 BPD 婴儿在 3 个月和 6 个月 CA 时运动技能获得和姿势不对称延迟。镇静药物与发育不良之间的关联表明,努力限制这些暴露可能会导致发育改善。促进早期运动发育的针对性干预可能会改善这一高风险人群的结局。

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