Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia.
Paediatr Perinat Epidemiol. 2022 Sep;36(5):673-682. doi: 10.1111/ppe.12867. Epub 2022 Feb 16.
Infants born extremely preterm (EP, <28-week gestational age) or extremely low birthweight (ELBW, <1000 g) are at risk of developmental delay and cerebral palsy (CP). The General Movements Assessment (GMA) and its extension, the Motor Optimality Score, revised (MOS-R) (assesses movement patterns and posture), may help to identify early delays.
To compare differences in the MOS-R scored from parent-recorded videos between infants born EP/ELBW and term-born infants, to determine relationships between the MOS-R and 2-year cognitive, language and motor outcomes and if any relationships differ between birth groups and the association of the GMA (fidgety) with CP.
A geographical cohort (EP/ELBW and term-control infants) was assessed using the MOS-R inclusive of the GMA at 3- to 4-month corrected age (CA), and the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) at 2-year CA. Differences in mean total MOS-R between groups, relationships between MOS-R and 2-year outcomes and relationships between GMA (fidgety) and CP in infants born EP/ELBW were estimated using linear/logistic regression.
Three hundred and twelve infants (147 EP/ELBW; 165 term) had complete MOS-R and Bayley-III assessments. Mean MOS-R was lower in infants born EP/ELBW than controls (mean difference -3.2, 95% confidence interval [CI] -4.2, -2.3). MOS-R was positively related to cognitive (β [regression coefficient] = 0.71, 95% CI 0.27, 1.15), language (β = 0.96, 95% CI 0.38, 1.54) and motor outcomes (β = .89, 95% CI 0.45, 1.34). There was little evidence for interaction effects between birth groups for any outcome. Absent/abnormal fidgety movements were related to CP in children born EP/ELBW (risk ratio 5.91, 95% CI 1.48, 23.7).
Infants born EP/ELBW have lower MOS-R than infants born at term. A higher MOS-R is related to better outcomes for 2-year development, with similar relationships in both birth groups. Absent/abnormal fidgety movements are related to CP in EP/ELBW survivors.
极早产儿（胎龄<28 周）或极低出生体重儿（体重<1000 克）存在发育迟缓及脑瘫（CP）风险。一般运动评估（GMA）及其延伸，即运动优化评分修订版（MOS-R）（评估运动模式和姿势），可能有助于早期识别发育迟缓。
比较 EP/ELBW 出生儿与足月出生儿的家长记录视频中 MOS-R 的评分差异，确定 MOS-R 与 2 岁时认知、语言和运动结局的关系，以及这些关系是否在不同出生组间存在差异，并探讨 GMA（烦躁不安）与 CP 的关系。
采用 MOS-R （包括 GMA）对 EP/ELBW 出生儿和足月对照组婴儿进行评估，评估时间为 3 至 4 月龄校正胎龄（CA），并在 2 岁 CA 时采用贝利婴幼儿发育量表，第三版（Bayley-III）进行评估。使用线性/逻辑回归估计两组间 MOS-R 总评分的均值差异、MOS-R 与 2 岁结局的关系，以及 EP/ELBW 出生儿中 GMA（烦躁不安）与 CP 的关系。
312 例婴儿（147 例 EP/ELBW；165 例足月）完成了 MOS-R 和 Bayley-III 评估。EP/ELBW 出生儿的 MOS-R 评分低于对照组（平均差异-3.2，95%置信区间[CI] -4.2，-2.3）。MOS-R 与认知（β [回归系数]=0.71，95%CI 0.27，1.15）、语言（β=0.96，95%CI 0.38，1.54）和运动结局（β=0.89，95%CI 0.45，1.34）呈正相关。任何结局均未见出生组间交互作用的证据。EP/ELBW 出生儿中，无/异常烦躁不安运动与 CP 相关（风险比 5.91，95%CI 1.48，23.7）。
EP/ELBW 出生儿的 MOS-R 评分低于足月出生儿。MOS-R 评分越高，2 岁时的发育结局越好，两组间的关系相似。EP/ELBW 存活儿中，无/异常烦躁不安运动与 CP 相关。
