Jackman Michelle, Morgan Catherine, Luke Carly, Korostenski Larissa, Zawada Katya, Juarez Michelle, Webb Annabel, Blatch-Williams Remy, Crowle Cathryn
Cerebral Palsy Alliance Research Institute, PO Box 171, Forestville, NSW 2087, Australia; John Hunter Children's Hospital, Lookout Rd, New Lambton Heights, NSW 2305, Australia; University of Sydney, Faculty of Medicine and Health, Camperdown, NSW 2006, Australia.
Cerebral Palsy Alliance Research Institute, PO Box 171, Forestville, NSW 2087, Australia; University of Sydney, Faculty of Medicine and Health, Camperdown, NSW 2006, Australia.
Early Hum Dev. 2025 Apr;203:106226. doi: 10.1016/j.earlhumdev.2025.106226. Epub 2025 Feb 27.
Infants born with congenital anomalies requiring surgery are at greater risk of developmental delays. Early screening tools are needed to identify infants who would benefit from early intervention. This study aimed to investigate the concurrent predictive validity of the General Movements Assessment (GMA), Motor Optimality Score - Revised (MOS-R), Hammersmith Infant Neurological Examination (HINE) and Bayley-III in identifying infants at risk of adverse neurodevelopmental outcomes.
A retrospective cohort study of 95 surgical infants. Participants were assessed at 3 months using the GMA, MOS-R, HINE, and Bayley-III. Development was assessed at 1 year using the Bayley-III. Logistic regression investigated the relationship between measures at 3 months and developmental outcome, using sensitivity, specificity, positive (PPV) and negative (NPV) predictive value and area under the ROC curve (AUC).
All assessments had a relationship with development. Combining assessments at 3 months did not increase predictive value. MOS-R < 23 or HINE<60 had >70 % sensitivity for identifying delays in ≥2 domains of the Bayley-III at 1 year, and > 80 % accuracy in ruling out infants not at risk. MOS-R < 23 (NPV 0.957), and HINE <60 (NPV 0.971) were significantly correlated with delayed cognition.
In a surgical cohort, the concurrent predictive validity of the GMA, MOS-R, HINE and Bayley-III, administered at 3 months of age was low, however all assessment tools showed correlations with outcomes. The HINE and MOS-R might help to identify infants who need support with cognition. Further exploration of early screening tools may help to identify infants who would benefit from early intervention.
患有先天性异常需要手术的婴儿出现发育迟缓的风险更高。需要早期筛查工具来识别那些将从早期干预中获益的婴儿。本研究旨在调查全身运动评估（GMA）、修订版运动最优性评分（MOS-R）、哈默史密斯婴儿神经学检查（HINE）和贝利婴幼儿发展量表第三版（Bayley-III）在识别有不良神经发育结局风险婴儿方面的同时预测效度。
对95名接受手术的婴儿进行回顾性队列研究。在3个月时使用GMA、MOS-R、HINE和Bayley-III对参与者进行评估。在1岁时使用Bayley-III评估发育情况。采用逻辑回归分析3个月时各项测量指标与发育结局之间的关系，计算敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV）以及ROC曲线下面积（AUC）。
所有评估均与发育有关。联合3个月时的各项评估并未提高预测价值。MOS-R<23或HINE<60对于识别1岁时贝利婴幼儿发展量表第三版中≥2个领域发育迟缓的敏感度>70%，排除无风险婴儿的准确率>80%。MOS-R<23（NPV 0.957）和HINE<60（NPV 0.971）与认知发育迟缓显著相关。
在一个手术队列中，3个月大时进行的GMA、MOS-R、HINE和Bayley-III的同时预测效度较低，然而所有评估工具均显示与结局存在相关性。HINE和MOS-R可能有助于识别需要认知支持的婴儿。进一步探索早期筛查工具可能有助于识别那些将从早期干预中获益的婴儿。
