Objective To study the application of the general and detailed assessment of writhing movement in very low birth weight (VLBW) infants follow-up for motor development. Methods A total of 50 VLBW infants ranging from December of 2009 to December of 2014 included in the Rehabilitation Department of Children's Hospital of Fudan University participated in the study.The motor development outcomes of the infants at 1 year old were determined according to clinical diagnoses and PDMS-2.The motor optimality score was assessed according to the detailed assessment of "Preterm and Term General Movement".The motor developmental score of the infants at 1 year old and the correlation coefficients between the motor optimality score and PDMS score were calculated. Results The predictive value of GMs assessment for neurological deficits (CP and motor retardation) was as followingsensitivity 100%, specificity 33.3%, positive predictive value 29.7%, and negative predictive value 100%; The predictive value of CS for CP was as followingsensitivity 55.6%, specificity 97.6%, positive predictive value 83.3%, and negative predictive value 90.9%.The median value of the 50 infants' motor optimality score was 24.The correlation degree between the motor optimality score and PDMS score of the infants at 1 year old was moderate. Conclusion In the motor developmental follow-up of VLBW infants, the writhing general movement assessment can be used as early indicators.
Key words
general movement /
video assessment /
very low birth weight /
preterm /
motor development
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Platt MJ.Long-term outcome for very preterm infants[J].Lancet, 2008, 371(9615):787-788.
[2] Marlow N, Wolke D, Bracewe MA, et al.Neurologic and developmental disability at six years of age after extremely preterm birth[J].N Eng J Med, 2005, 352(1):9-19.
[3] Prechtl HFR.General movement assessment as a method of developmental neurology:new paradigms and their consequences[J].Developmental Medicine & Child Neurology, 2001, 43(12):836-842.
[4] Prechtl HF.Qualitative changes of spontaneous movements in fetus and preterm infant are a marker of neurological dysfunction[J].Early Hum Dev, 1990, 23(3):151-158.
[5] 杨红.脑瘫儿的超早期筛查技术--全身运动评估在中国的研究进展[M].上海:上海科学普及出版社, 2010.
[6] Fjortoft T, Einspieler C, Adde L, et al.Inter-observer reliability of the "Assessment of Motor Repertoire-3 to 5 Months" based on video recordings of infants[J].Early Hum Dev, 2009, 85(5):297-302.
[7] 陈鸣, 杨红, 侯方华, 等.全身运动评估对极低出生体重早产儿运动发育结局的预测价值[J].中国儿童保健杂志, 2012, 20(12):1067-1069.
[8] Nakajima Y, Einspieler C, Marschik PB, et al.Does a detailed assessment of poor repertoire general movements help to identify those infants who will develop normally?[J].Early Hum Dev, 2006, 82(1):53-59.
[9] Rosenbaum P, Paneth N, Leviton A, et al.A report:the definition and classification of cerebral palsy April 2006[J].Dev Med Child Neurol, 2007, 109:8-14.
[10] 翟倩, 曹云, 王艺, 等.不同时期极低和超低出生体重儿神经发育预后比较[J].中国儿童保健杂志, 2014, 22(1):7-9.
[11] 杨红, 史惟, 邵肖梅, 等.全身运动质量评估对高危新生儿神经学发育结局信度和预测效度的研究[J].中国循证儿科杂志, 2007, 12(3):172-180.
[12] 刘江勤, 黄丽萍, 严虎, 等.极低出生体重早产儿143例结局[J].中国新生儿科杂志, 2012, 27(4):243-246.
[13] 杨红.全身运动(GMs)评估在高危儿运动发育随访中的应用研究[D].上海:复旦大学, 2009.
[14] Yang H, Einspieler C, Shi W, et al.Cerebral palsy in children:movements and postures during early infancy, dependent on preterm vs.full term birth[J].Early Hum Dev, 2012, 88(10):837-843.
PDF(578 KB)
