关键词: 不安运动, 早产儿, 运动发育结局, 预测效度
中图分类号:R722 文献标识码:A 文章编号:1008-6579(2015)08-0794-03 doi:10.11852/zgetbjzz2015-23-08-04

Abstract: Objective To compare the validity and concordance in the motor developmental outcomes of General Movements assessment (GMs) with that of Gesell Developmental Test Scale (GDS)among premature infants.Methods 226 premature infants doing physical examination and follow-up in Department of Children's Health Care of our hospital during June 2011 to June 2013 were evaluated with GMs assessment and Gesell Developmental Test Scale.Cerebral palsy was evaluated and the motor development was assessed by Peabody Development Motor Scale 2 (PDMS-2) in correct gestational age 12 month.Compare the predictive validity (sensitivity,specificity,positive predictive value and negative predictive value) and motor development of the two methods.Results There were 28 cerebral palsy patients and 22 infants with motor retardation among the 226 premature infants，meanwhile 176 were normal.For the fidgety movements of GMs,168 infants were assessed as normal,58 were abnormal.GDS assessment results:There were 140 infants were assessed as normal and 86 infants were abnormal.The fidgety movements of GMs assessments and GDS assessment sensitivity for cerebral palsy was 92.9%,71.4%,its specificity was 83.8%,66.7%,its positive predictive value was 44.8%,23.3%，its negative predictive value was 98.8%,94.3%.The fidgety movements of GMs assessments and GDS assessment sensitivity for motor development outcome was 88.0%,68.0%,its specificity was 92.0%,70.4%,its positive predictive value was 75.9%,39.5%，its negative predictive value was 96.4%,88.6%.The Kappa value for consistency checks of GDS and PDMS-2 was 0.306，p<0.05.The p value for consistency checks of GMs and PDMS-2 was 0.757，P<0.05.The results hint that a good consistency of GMs and GDS and PDMS-2.The consistency of prediction and assessment result of fidgety movements was higher than other methods.Conclusions Fidgety movements of GMs can make early prediction of cerebral palsy and other severe neurological deficits.It is better than the traditional method neurological examination in predicting prognosis.

Key words: fidgety movements, premature infant, motor developmental outcome, predictive validity