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患有妊娠期糖尿病和/或先兆子痫的母亲所生婴儿是否存在发育问题的风险?

Is there a risk of developmental problems in infants born to mothers with gestational diabetes mellitus and/or pre-eclampsia?

作者信息

Yardımcı-Lokmanoğlu Bilge Nur, Topal Yusuf, Kınacı-Biber Esra, Arıkan Zeynep, Sırtbaş-Işık Gülsen, Porsnok Doğan, Çelik Hasan Tolga, Mutlu Akmer

机构信息

Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye.

School of Physical Therapy and Rehabilitation, Ahi Evran University, Kırşehir, Türkiye.

出版信息

PLoS One. 2025 Jan 24;20(1):e0318003. doi: 10.1371/journal.pone.0318003. eCollection 2025.

Abstract

OBJECTIVE

The aims of this study were (i) to describe the early spontaneous movements in 3-to 5-month-old infants in groups of infants born to mothers with GDM and/or PE, (ii) to compare them, and (iii) to analyze the differences between infants with these risk factors and typically developing infants born to mothers without GDM and/or PE and other risk factors.

METHODS

This cohort study included 255 infants in 4 groups: (i) 96 infants born to mothers with GDM, (ii) 78 infants born to mothers with PE, (iii) 31 infants born to mothers with GDM and PE, and (iv) 50 typically developing infants. Early spontaneous movements, including not only fidgety movements but also concurrent movement and postural patterns, were assessed using the General Movements Assessment (GMA), which determines the Motor Optimality Score-Revised (MOS-R). Comparisons were made using one-way ANOVA for normally distributed continuous variables, Kruskal-Wallis test for non-normally distributed data, and Pearson chi-squared for categorical variables. Univariate logistic regression analyses were used to determine the odds ratios (OR) with 95% confidence intervals (CI).

RESULTS

There were no differences between the three groups, which included infants whose mothers had at least one of these risk factors (p>0.05). Infants born to mothers with GDM, infants born to mothers with PE, and infants born to mothers with both GDM and PE had more aberrant fidgety movements, reduced age-adequate movement repertoire, and more abnormal postural patterns than typically developing infants (p<0.05), in addition to lower MOS-R. When looking at those with ≤24 in MOS-R, the odds ratios were ≥2.74.

CONCLUSION

Findings suggest that early spontaneous movements, GMA, may play a crucial role in understanding developmental outcomes of these infants and in determining infants who need early intervention.

摘要

目的

本研究的目的是:(i)描述患有妊娠期糖尿病(GDM)和/或先兆子痫(PE)的母亲所生婴儿组中3至5个月大婴儿的早期自发运动;(ii)对这些运动进行比较;(iii)分析具有这些风险因素的婴儿与没有GDM和/或PE及其他风险因素的母亲所生的正常发育婴儿之间的差异。

方法

这项队列研究纳入了4组共255名婴儿:(i)96名患有GDM的母亲所生的婴儿;(ii)78名患有PE的母亲所生的婴儿;(iii)31名患有GDM和PE的母亲所生的婴儿;(iv)50名正常发育的婴儿。使用全身运动评估(GMA)对早期自发运动进行评估,该评估不仅包括不安运动,还包括同步运动和姿势模式,并确定修订后的运动最优性评分(MOS-R)。对于正态分布的连续变量,使用单因素方差分析进行比较;对于非正态分布的数据,使用Kruskal-Wallis检验;对于分类变量,使用Pearson卡方检验。单因素逻辑回归分析用于确定具有95%置信区间(CI)的比值比(OR)。

结果

包括母亲至少有其中一种风险因素的三组婴儿之间没有差异(p>0.05)。与正常发育的婴儿相比,患有GDM的母亲所生的婴儿、患有PE的母亲所生的婴儿以及患有GDM和PE的母亲所生的婴儿具有更多异常的不安运动、年龄适宜的运动技能减少、更多异常的姿势模式(p<0.05),此外MOS-R更低。当观察MOS-R≤24的婴儿时,比值比≥2.74。

结论

研究结果表明,早期自发运动,即GMA,可能在理解这些婴儿的发育结局以及确定需要早期干预的婴儿方面发挥关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24f4/11760038/8de900b70c51/pone.0318003.g001.jpg

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