Montgomery Cecilia, Setänen Sirkku, Kaul Ylva Fredriksson, Farooqi Aijaz, Broström Lina, Aden Ulrika, Källén Karin, Serenius Fredrik
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Department of Neonatology: Child and Adolescent Medicine, Umeå University Hospital, Umeå, Sweden.
Acta Paediatr. 2023 Apr;112(4):742-752. doi: 10.1111/apa.16694. Epub 2023 Feb 20.
To investigate the predictive ability of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) Motor Index, in children born extremely preterm (<27 gestational weeks) without cerebral palsy.
Children from the EXPRESS study (all extremely preterm births in Sweden, 2004-2007) without neurosensory impairments assessed with Bayley-III at 2.5 years corrected age and Movement Assessment Battery for Children, Second Edition (MABC-2), at 6.5 years comprised the eligible study population (n = 282). Motor difficulty was defined as MABC-2 ≤5th percentile.
Motor difficulties were found in 57 of 282 children (20.2%) at 6.5 years. The Bayley-III explained 18.0% of the variance in the MABC-2 (p < 0.001). The area under the receiver operating curve was 0.71 (95% confidence interval 0.64-0.79, p < 0.001). At a Bayley-III cut-off value of 85, sensitivity, specificity and positive and negative predictive values for motor difficulties were 26.3% (15.5-39.7), 92.9% (88.1-95.9), 48.4% (33.0-64.0) and 83.3% (80.9-85.4). Likelihood ratios were inconclusive.
The Bayley-III at 2.5 years corrected age was a modest predictor of motor outcome in children born extremely preterm at 6.5 years, and underestimated the rate of motor difficulties. Children require follow-up beyond preschool age.
探讨贝利婴幼儿发展量表第三版（Bayley-III）运动指数对极早产儿（孕周<27周）且无脑瘫儿童的预测能力。
来自EXPRESS研究（瑞典2004 - 2007年所有极早产出生儿）的儿童，在矫正年龄2.5岁时用Bayley-III进行评估，在6.5岁时用儿童运动评估量表第二版（MABC-2）进行评估，且无神经感觉障碍，构成符合条件的研究人群（n = 282）。运动困难定义为MABC-2≤第5百分位数。
282名儿童中有57名（20.2%）在6.5岁时存在运动困难。Bayley-III解释了MABC-2中18.0%的变异（p< 0.001）。受试者工作特征曲线下面积为0.71（95%置信区间0.64 - 0.79，p< 0.001）。当Bayley-III临界值为85时，运动困难的敏感性、特异性、阳性预测值和阴性预测值分别为26.3%（15.5 - 39.7）、92.9%（88.1 - 95.9）、48.4%（33.0 - 64.0）和83.3%（80.9 - 85.4）。似然比尚无定论。
矫正年龄2.5岁时的Bayley-III对极早产儿6.5岁时的运动结局是一个中等程度的预测指标，且低估了运动困难的发生率。儿童需要在学龄前之后继续接受随访。
