婴儿运动能力测试在早产儿发育评估中的应用

Test of Infant Motor Performance in the developmental assessment of preterm infants

目的通过运用婴儿运动能力测试(TIMP)方法评估不同孕周早产儿运动发育特点及相关性,从而更好地根据TIMP测试结果制定个体化早期干预措施。方法对2019年6月至2021年7月在三二〇一医院出生并随访的43名足月健康儿和77名早产儿进行前瞻性研究,早产儿按照出生胎龄分为早期早产组(39例)和晚期早产组(38例),分别在胎龄40周及出生矫正年龄16周进行TIMP测评,足月健康组出生16周龄行TIMP测评,组间差异行方差分析或Mann-Whitney秩和检验,相关性行Pearson相关分析。结果早期早产儿和晚期早产儿在胎龄40周[(65.74±6.52)分比(66.96±8.51)分]和矫正年龄16周[(101±10)分比(104±8)分]时TIMP评分差异均无统计学意义(均P>0.05);矫正年龄16周时足月组TIMP值[(108±10)分],与早期和晚期早产儿比较差异有统计学意义(P<0.05),其中,早期早产组和晚期早产组的观察、仰卧位、仰卧位翻身3部分TIMP评分较足月组降低(均P<0.05),立位部分值较足月组升高(P<0.05);早期早产儿组和晚期早产儿组胎龄40周与矫正年龄16周TIMP值均呈正相关(r=0.565、0.302,均P<0.01)。结论不同胎龄早产儿与足月儿运动发育特点存在差异,对早期干预有指导意义,英文版TIMP测评对我国早产儿随访个性化评估及早期干预工作开展有积极的促进作用。

Objective To assess the characteristics and correlation of motor development in preterm infants of different gestational weeks by using the Test of Infant Motor Performance(TIMP)method,and to develop better individualized early interventions based on TIMP test results.Methods A prospective study involving 43 full-term healthy infants and 77 preterm followed up in 3201 Hospital from June 2019 to July 2021 was conducted.Preterm infants were divided into the early preterm group(39 cases)and late preterm group(38 cases)according to their gestational age at birth.TIMP assessment was performed at the gestational age of 40 weeks and the corrected age of 16 weeks after birth.Similarly,the full-term healthy infants were assessed by TIMP at the postnatal age of 16 weeks.The differences between groups were investigated using ANOVA or Mann-Whitney rank sum test.Correlations were analyzed by the Pearson correlation method.Results There were no significant difference in TIMP scores between early and late preterm infants at the gestational age of 40 weeks[(65.74±6.52)scores vs.(66.96±8.51)scores]and the corrected age of 16 weeks[(101±10)scores vs.(104±8)scores](all P>0.05).TIMP scores in the full-term healthy group at the corrected age of 16 weeks[(108±10)scores]differed significantly from those of early and late preterm infants(P<0.05).Compared with full-term infants,early and late preterm infants had lower TIMP scores in observation,supine position,and supine turning(all P<0.05),but a higher TIMP score in standing position(P<0.05).For both early and late preterm infants,TIMP scores at the gestational age of 40 weeks were significantly positively correlated with those at the corrected age of 16 weeks(r=0.565,0.302,all P<0.01).Conclusions There were significant differences in motor development between preterm infants of different gestational ages and term infants,which had guiding significance for early intervention.English version TIMP could play a positive role in promoting individualized follow-up and early intervention of preterm infants in China.