Kadam Archana S, Nayyar Sidharth A, Kadam Sandeep S, Patni Bindu C, Khole Madhura C, Pandit Anand N, Kabra Nandkishor S
Department of Pediatrics, KEM Hospital and Research Centre, Rasta Peth, Pune, Maharashtra, India.
Surya Hospital, Mumbai, India.
J Pediatr X. 2022 Dec 17;8:100084. doi: 10.1016/j.ympdx.2022.100084. eCollection 2023 Spring.
To assess the association between the General Movement Assessment (GMA) findings, including Motor Optimality Scores-Revised (MOS-R) at 16 weeks, and neuromotor outcome assessed by the Amiel-Tison Neurological Assessment at 9 months of corrected age and the Developmental Assessment Scales for Indian Infants (DASII) at 1 year of corrected age in preterm ≤32 weeks.
Serial GMA videos of infants born preterm ≤32 weeks were recorded on day 7, 35 weeks of postmenstrual age, 40 weeks of postmenstrual age, and 16 weeks of corrected age. The association between GMA findings, including MOS-R scores and GM trajectory between 35 to 40 weeks and the Amiel-Tison Neurological Assessment and DASII scores, was assessed by Spearman correlation, Fisher exact tests, and ordinal regression.
Moderate correlations were observed between MOS-R and the DASII motor DQ (Spearman r = 0.70, < .001) and between MOS-R and DASII Mental DQ (r = 0.65, < .001). The GMA trajectory at 35-40 weeks was associated with DASII motor DQ (Fisher exact, = .002), and also with the Amiel-Tison Neurological Assessment at 9 months of corrected age ( < .01 by the Fisher exact test). On analysis by performing ordinal regression of predictive values of the general movements (GM) at 7 days of age, GM at 35 weeks, GM at 40 weeks, GM at 16 weeks, and MOS-R at 16 weeks, MOS-R alone was a statistically significant predictor of motor DQ at 1 year of age (OR -0.59; 95% CI -0.97 to -0.22; Wald statistics, < .02).
Consistent with findings in high-income countries, GMA including MOS-R scores performed in Indian infants born preterm during the neonatal period and early infancy is associated with neurodevelopmental outcomes in the first year of life. GMA can help initiate focused early intervention in low- and middle-income settings, where resources may be limited.
评估一般运动评估（GMA）结果（包括16周时的运动优化评分修订版（MOS-R））与经校正年龄9个月时通过阿米尔-蒂松神经学评估以及经校正年龄1岁时通过印度婴儿发育评估量表（DASII）评估的神经运动结局之间的关联，研究对象为孕周≤32周的早产儿。
对孕周≤32周的早产儿在出生后第7天、月经龄35周、月经龄40周以及校正年龄16周时进行GMA系列视频记录。通过Spearman相关性分析、Fisher精确检验和有序回归分析评估GMA结果（包括MOS-R评分以及35至40周之间的一般运动轨迹）与阿米尔-蒂松神经学评估和DASII评分之间的关联。
观察到MOS-R与DASII运动发育商（Spearman相关系数r = 0.70，P <.001）以及MOS-R与DASII智力发育商（r = 0.65，P <.001）之间存在中度相关性。35至40周时的GMA轨迹与DASII运动发育商相关（Fisher精确检验，P =.002），并且与校正年龄9个月时的阿米尔-蒂松神经学评估也相关（Fisher精确检验，P <.01）。通过对出生后第7天、35周、40周、16周时的一般运动（GM）以及16周时的MOS-R的预测值进行有序回归分析，发现仅MOS-R是1岁时运动发育商的统计学显著预测指标（比值比-0.59；95%置信区间-0.97至-0.22；Wald统计量，P <.02）。
与高收入国家的研究结果一致，在印度新生儿期和婴儿早期出生的早产儿中进行的包括MOS-R评分的GMA与生命第一年的神经发育结局相关。在资源可能有限的中低收入环境中，GMA有助于启动有针对性的早期干预。
