Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
BMC Pediatr. 2024 Sep 21;24(1):598. doi: 10.1186/s12887-024-05046-w.
Exposure to alcohol and/or other addictive drugs in pregnancy is a documented risk factor for neurological impairment. We aimed to assess neurodevelopmental outcome at two years of age in infants exposed to prenatal alcohol and/or other addictive drugs and to examine the predictive value of early motor assessment.
This was a follow-up at two years of age in the prospective cohort study Children Exposed to Alcohol and/or Drugs in Intrauterine Life (CEADIL). The exposed group comprised 73 infants recruited from primary health care and included in a hospital follow-up programme at St. Olavs Hospital, Trondheim University Hospital, Norway. The control group comprised 93 healthy, unexposed infants recruited from the maternity ward at the same hospital. All children had been assessed by physiotherapists using the General Movement Assessment (GMA) at three months of age. Presence of fidgety movements, movement character and the Motor Optimality Score - Revised (MOS-R) were used. At two years of age, the children were assessed by trained examiners using the Bayley Scales of Infant and Toddler Development - Third Edition (BSID-III), Ages & Stages Questionnaires: Social-Emotional (ASQ:SE) and the Hollingshead Two-Factor Index of Social Position (SES).
The cognitive, language and motor composite scores of BSID-III were considerably lower in the exposed group than in the control group. Mean differences adjusted for age and parental SES ranged from - 13.3 (95% confidence interval, CI: -18.6 to -8.0) to -17.7 (95% CI: -23.3 to -12.2). Suboptimal fidgety movements and monotonous movement character had high sensitivity (0.94 to 0.74), but low specificity (0.10 to 0.32), while sensitivity and specificity of the MOS-R was around 50 and 60%, respectively.
Neurodevelopmental outcome at two years of age was poorer in a group of children exposed to alcohol and/or drugs in pregnancy compared with a control group of healthy, unexposed children. Sensitivity of suboptimal fidgety movements and monotonous movement character at three months of age for later neurodevelopmental outcome was high to acceptable, but the MOS-R had limited sensitivity.
孕期暴露于酒精和/或其他成瘾性药物是导致神经发育受损的已证实风险因素。我们旨在评估在产前暴露于酒精和/或其他成瘾性药物的婴儿在两岁时的神经发育结局，并检验早期运动评估的预测价值。
这是前瞻性队列研究“宫内暴露于酒精和/或药物的儿童（CEADIL）”的两岁随访研究。暴露组由从初级保健机构招募的 73 名婴儿组成，并纳入挪威特隆赫姆大学医院圣奥拉夫医院的医院随访计划。对照组由来自同一医院产科病房的 93 名健康、未暴露的婴儿组成。所有儿童在三个月大时均由物理治疗师使用全身运动评估（GMA）进行评估。评估内容包括活跃运动、运动特征和运动优化评分修订版（MOS-R）。在两岁时，由经过培训的检查人员使用贝利婴幼儿发育量表第三版（BSID-III）、年龄与阶段问卷：社会情感（ASQ：SE）和霍林斯黑德社会地位两因素指数（SES）对儿童进行评估。
暴露组的 BSID-III 认知、语言和运动综合评分明显低于对照组。经年龄和父母社会经济地位调整后的平均差异范围为-13.3（95%置信区间，CI：-18.6 至-8.0）至-17.7（95% CI：-23.3 至-12.2）。三个月时的非最佳活跃运动和单调运动特征具有较高的敏感性（0.94 至 0.74），但特异性较低（0.10 至 0.32），而 MOS-R 的敏感性和特异性分别约为 50%和 60%。
与健康、未暴露的对照组儿童相比，在一组产前暴露于酒精和/或药物的儿童中，两岁时的神经发育结局较差。三个月时非最佳活跃运动和单调运动特征的敏感性较高（0.94 至 0.74），提示其对以后的神经发育结局具有可接受的预测价值，但 MOS-R 的敏感性有限。
