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高危儿的运动最优得分显著低于中晚期早产儿。

Motor Optimality Scores are significantly lower in a population of high-risk infants than in infants born moderate-late preterm.

机构信息

Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA.

Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA.

出版信息

Early Hum Dev. 2022 Nov;174:105684. doi: 10.1016/j.earlhumdev.2022.105684. Epub 2022 Oct 1.

Abstract

BACKGROUND

The Motor Optimality Score-Revised (MOS-R) is a detailed scoring of the General Movement Assessment (GMA), measuring the spontaneous behaviors of infants. Infants born moderate-late preterm are not traditionally followed in high-risk clinics, but have increased risk of neurodevelopmental disability.

AIMS

Compare MOS-R at 3 months corrected age (CA) in high-risk (HR; very preterm or abnormal neuroimaging) infants to infants born moderate-late preterm (MLP).

STUDY DESIGN

In this prospective cohort study, parents of enrolled infants created video recordings using an app at 3 months CA. Videos were scored with the General Movement Assessment (GMA) and MOS-R. MOS-R scores were divided into "higher-risk" (≤19) and "lower-risk" (≥20).

SUBJECTS

181 infants born MLP or categorized as HR.

RESULTS

Among enrolled infants, 68 (38 %) were in the MLP group, and 113 infants were in the HR group. The HR group had 3.8 increased odds of having an aberrant GMA score compared to the MLP group (p < 0.01, 95 % CI 1.38-10.52). The HR group had significantly lower MOS-R scores (mean 20) than the MLP group (mean 24; p < 0.001; 95%CI 3.3-7.3). The HR group had 11.2 increased odds of having a higher-risk MOS-R score (95%CI 2.5-47.6, p < 0.001) than MLP group. Infants were most likely to have a lower MOS-R score if they had any of the following: VP shunt placement, periventricular leukomalacia, or bronchopulmonary dysplasia.

CONCLUSIONS

Aberrant GMA and higher-risk MOS-R scores were more common in infants at high-risk, reflecting history of brain lesions and younger gestational age at birth.

摘要

背景

运动优化评分修订版(MOS-R)是对全身运动评估(GMA)的详细评分,用于测量婴儿的自发性运动。中晚期早产儿传统上不在高危诊所中接受随访,但存在神经发育障碍的风险增加。

目的

比较高危(HR;极早产儿或异常神经影像学)婴儿和中晚期早产儿(MLP)在 3 个月校正年龄(CA)时的 MOS-R。

研究设计

在这项前瞻性队列研究中,入组婴儿的父母在 3 个月 CA 时使用应用程序创建视频记录。视频使用全身运动评估(GMA)和 MOS-R 进行评分。MOS-R 评分分为“高风险”(≤19)和“低风险”(≥20)。

受试者

181 名中晚期早产儿或归类为 HR 的婴儿。

结果

在入组婴儿中,68 名(38%)为 MLP 组,113 名婴儿为 HR 组。与 MLP 组相比,HR 组出现异常 GMA 评分的可能性增加了 3.8 倍(p<0.01,95%CI 1.38-10.52)。HR 组的 MOS-R 评分明显低于 MLP 组(均值 20)(p<0.001;95%CI 3.3-7.3)。HR 组出现高风险 MOS-R 评分的可能性增加了 11.2 倍(95%CI 2.5-47.6,p<0.001),高于 MLP 组。如果婴儿有脑室-心房分流术、脑室周围白质软化或支气管肺发育不良等情况,他们最有可能出现较低的 MOS-R 评分。

结论

高危婴儿中更常见异常 GMA 和高风险 MOS-R 评分,反映了脑损伤病史和出生时的胎龄较小。

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