Newcastle upon Tyne Hospitals NHS Foundation Trust (NuTH), Newcastle Neonatal Service, Ward 35 Leazes Wing, Royal Victoria Infirmary, Richardson Road, Newcastle upon Tyne NE1 4LP, England, UK; Newcastle University, Population Health Sciences Institute, Faculty of Medical Sciences, Level 3 Sir James Spence Institute (Child Health), Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
Newcastle upon Tyne Hospitals NHS Foundation Trust (NuTH), Newcastle Neonatal Service, Ward 35 Leazes Wing, Royal Victoria Infirmary, Richardson Road, Newcastle upon Tyne NE1 4LP, England, UK.
Early Hum Dev. 2022 Jul;170:105589. doi: 10.1016/j.earlhumdev.2022.105589. Epub 2022 May 21.
The LAPI, cUS and GMA are assessments used clinically in the UK to identify preterm infants at high risk of neurodevelopmental disabilities such as cerebral palsy. This study investigated the ability of these assessments to predict cerebral palsy at 2 years corrected gestational age.
Design: Prospective longitudinal cohort study including infants born <30 weeks' gestation from a single tertiary neonatal intensive care unit. The LAPI and cUS were undertaken as part of routine care before term equivalent age and the GMA was undertaken at 11-18 weeks corrected gestational age.
There were 123 eligible infants and 95 infants (77.2%) were included. Thirteen infants (13.7%) had a diagnosis of CP at 2 years. There was no significant difference in gestational age, gender, or birth weight between the groups with and without a diagnosis of CP. The highest accuracy of prediction of CP was achieved by an aberrant, absent fidgety general movements classification with a sensitivity of 92.3% and specificity of 98.9%. Combining the GMA to include the cUS or LAPI did not increase the predictive accuracy.
The GMA when undertaken in clinical practice had high accuracy for predicting CP at 2 years corrected age in infants born <30 weeks gestation; LAPI and cUS did not improve this accuracy.
LAPI、cUS 和 GMA 是英国临床上用于识别存在脑瘫等神经发育障碍高危风险的早产儿的评估方法。本研究旨在探讨这些评估方法在预测校正胎龄 2 岁时脑瘫的能力。
设计：这是一项包括来自单一三级新生儿重症监护病房的 <30 周胎龄婴儿的前瞻性纵向队列研究。LAPI 和 cUS 在接近足月时作为常规护理的一部分进行，GMA 在校正胎龄 11-18 周进行。
共有 123 名符合条件的婴儿，其中 95 名婴儿（77.2%）被纳入研究。13 名婴儿（13.7%）在 2 岁时被诊断为脑瘫。有无脑瘫诊断的两组在胎龄、性别或出生体重方面无显著差异。最准确预测脑瘫的是出现异常、缺失的不安定一般性运动分类，其敏感性为 92.3%，特异性为 98.9%。将 GMA 与 cUS 或 LAPI 结合使用并不能提高预测准确性。
在临床实践中进行的 GMA 对预测 <30 周胎龄出生婴儿校正胎龄 2 岁时的脑瘫具有很高的准确性；LAPI 和 cUS 并未提高这一准确性。
