不安运动阶段全身运动评估对晚期早产儿运动发育结局的预测价值

Predictive value of general movement assessment during fidgety movement period for motor development outcome of late premature infants

目的探讨不安运动阶段全身运动评估对晚期早产儿运动发育结局的预测价值,以期为晚期早产儿的早期康复干预提供依据。方法通过检索儿科诊疗应用系统确定研究对象,应用门诊系统、PDMS评估系统、电话随访及微信随访等形式获得12月龄以上的运动发育结局。分析不安运动阶段全身运动评估对脑瘫、不良运动发育结局(脑瘫和运动发育迟缓)及正常运动发育结局预测的灵敏度、特异度、阳性预测值及阴性预测值。结果共纳入晚期早产儿39例,其中10例不安运动缺乏(F-)(25.64%),29例正常不安运动(NF)(74.36%);6例脑瘫(15.38%),4例运动发育迟缓(10.26%),29例正常(74.36%)。不安运动阶段全身运动评估预测异常运动发育结局的灵敏度为90.00%(9/10),特异度为96.55%(28/29),阳性预测值为90.00%(9/10),阴性预测值为96.55%(28/29)。不安运动阶段灵敏度评估对晚期早产儿脑瘫结局的预测灵敏度为100.00%(6/6),特异度为87.88%(29/33),阳性预测值为60.00%(6/10),阴性预测值为100.00%(29/29)。结论不安运动阶段全身运动评估对晚期早产儿的运动发育结局(脑瘫和运动发育迟缓)具有良好的预测价值,可在晚期早产儿脑发育随访工作中进行推广应用。

Objective To explore the predictive value of general movement assessment during fidgety movement period for motor development outcome of late premature infants,and provide a reference basis for early rehabilitation and intervention.Methods Pediatric diagnosis and treatment application system was searched to determine the research object,outpatient service system,PDMS evaluation system,telephone follow-up,and We Chat follow-up were performed to obtain motor development outcome of premature infants more than 12 months.The sensitivities,specificities,positive predictive values,and negative predictive values of general movement assessment during fidgety movement period for predicting cerebral palsy,adverse motor development outcome(cerebral palsy and motor retardation),and normal motor development outcome were analyzed.Results Thirty-nine late premature infants were enrolled into this study,including 10 cases of fidgety movement deficiency(F-)(25.64%)and 29 cases of normal fidgety movement(NF)(74.36%);6 cases(15.38%)with cerebral palsy,4 cases(10.26%)with motor retardation,and 29 normal cases(74.36%)were diagnosed.The sensitivity,specificity,positive predictive value,and negative predictive value of general movement assessment during fidgety movement period for predicting adverse motor development outcome were 90.00%(9/10),96.55%(28/29),90.00%(9/10),and 96.55%(28/29),respectively.The sensitivity,specificity,positive predictive value,and negative predictive value of general movement assessment during fidgety movement period for predicting cerebral palsy were 100.00%(6/6),87.88%(29/33),60.00%(6/10),and 100.00%(29/29),respectively.Conclusion The predictive value of general movement assessment during fidgety movement period for motor development outcome(cerebral palsy and motor retardation)of late premature infants is good,which can be promoted and applied in cerebral development follow-up of late premature infants.