See Mandi Suet Ning, Ereno Imelda Lustestica, Teh Wan Ying, Baral Vijayendra Ranjan, Vaughan Roger Daniel, Yeo Cheo Lian
Duke-NUS Medical School, Singapore.
Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Early Hum Dev. 2024 Mar;190:105973. doi: 10.1016/j.earlhumdev.2024.105973. Epub 2024 Feb 14.
To determine the agreement between HNNE and TIMP at TCA for preterm infants born <32 weeks' gestation, and to evaluate their correlation to PDMS-2 at 12-month corrected age (CA).
Infants born between November 2013 to June 2022 who had both HNNE and TIMP performed at TCA of 37-41 weeks gestation, and motor outcome assessed using the PDMS-2 at 12-month old were enrolled. The HNNE and 12-month PDMS-2 findings were categorized as optimal vs sub-optimal. TIMP was categorized as typical vs atypical. Cohen's kappa was used to determine the agreement between HNNE and TIMP. Sensitivity analysis and Receiver Operating Characteristic (ROC) curves were used to evaluate the predictive values of HNNE and TIMP on motor outcome at CA of 12-months.
HNNE and TIMP done on 125 infants at TCA do not show reliable agreement. HNNE demonstrated slight and fair agreement with the 12-month Total Motor Quotient (TMQ) and Fine Motor Quotient (FMQ) of the PDMS-2 respectively. TIMP at TCA demonstrated fair agreement with all sub-domains of motor function on PDMS-2 at 12-months. In comparison with TIMP, HNNE at TCA is more sensitive at predicting suboptimal total, gross and fine motor outcomes at 12-month CA with sensitivity of 68.4 %, 51.9 %, and 83.3 % vs 44.4 %, 31.8 % and 53.3 % respectively. Atypical TIMP at TCA is more specific for suboptimal total, gross and fine motor outcomes at 12-month CA with specificity of 90.3 %, 89 % and 90.5 % respectively. Neurobehavioral assessments at TCA using HNNE and TIMP were predictive of suboptimal fine motor quotient at CA of 12-months with AUC of 0.760 (p = 0.011) and 0.718 (p = 0.032) respectively. The difference in AUC between the 2 instruments of 0.042 was not statistically significant (p = 0.741).
While the HNNE and TIMP done at TCA did not demonstrate significant agreement, suboptimal HNNE and atypical TIMP at TCA were predictive of suboptimal FMQ on PDMS-2 at 12-month CA.
确定胎龄小于32周的早产儿在纠正胎龄（TCA）37 - 41周时HNNE和TIMP之间的一致性，并评估它们与12个月纠正年龄（CA）时的PDMS - 2的相关性。
纳入2013年11月至2022年6月出生的婴儿，这些婴儿在胎龄37 - 41周的TCA时进行了HNNE和TIMP检查，并在12个月大时使用PDMS - 2评估运动结局。将HNNE和12个月时的PDMS - 2检查结果分为最佳与次优。TIMP分为典型与非典型。使用Cohen's kappa来确定HNNE和TIMP之间的一致性。敏感性分析和受试者工作特征（ROC）曲线用于评估HNNE和TIMP对12个月CA时运动结局的预测价值。
对125名婴儿在TCA时进行的HNNE和TIMP检查未显示出可靠的一致性。HNNE与PDMS - 2的12个月总运动商（TMQ）和精细运动商（FMQ）分别显示出轻微和中等程度的一致性。TCA时的TIMP与12个月时PDMS - 2的所有运动功能子领域显示出中等程度的一致性。与TIMP相比，TCA时的HNNE在预测12个月CA时次优的总运动、粗大运动和精细运动结局方面更敏感，敏感性分别为68.4%、51.9%和83.3%，而TIMP的敏感性分别为44.4%、31.8%和53.3%。TCA时非典型TIMP对12个月CA时次优的总运动、粗大运动和精细运动结局更具特异性，特异性分别为90.3%、89%和90.5%。在TCA时使用HNNE和TIMP进行的神经行为评估可预测12个月CA时次优的精细运动商，AUC分别为0.760（p = 0.011）和0.718（p = 0.032）。两种工具的AUC差异为0.042，无统计学意义（p = 0.741）。
虽然在TCA时进行的HNNE和TIMP未显示出显著一致性，但TCA时次优的HNNE和非典型TIMP可预测12个月CA时PDMS - 2上的次优FMQ。
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