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Objective To study the predictive value of general movements( GMs) quality assess-ment technique(writhing movements)on the motor development outcome of high-risk infants,so as to pro-vide a reference basis for clinical diagnosis and treatment. Methods A retrospective analysis was made on the high-risk infants who were hospitalized in the Neonatal Department of the Affiliated Hospital of Inner Mongolia Medical University from January 1,2017 to December 31,2018,and the GMs quality assessment was finished and followed up to 12-month-old among high-risk infants. The clinical diagnostic criteria for patients with cerebral palsy and Peabody Development Motor Scales-2 ( PDMS-2) were used to evaluate the motor development outcome of 12-month-old high-risk infants. Furthermore, the predictive value of GMs writhing movements on the motor development outcome of high-risk infants were evaluated. Results The predictive validity of writhing movements phase[cramped synchronized(CS) +poor repertoire(PR)]for mo-tor retardation and cerebral palsy in high-risk infants who met the inclusion criteria were as follows:the sensi-tivity,specificity, positive predictive value, negative predictive value were 94. 44%, 23. 03%, 11. 04%, 97. 62% and 100%,21. 88%,2. 60%,100%,respectively. The predictive sensitivity and negative predictive value of writhing movements PR for motor retardation and cerebral palsy were 92. 31%,100%;98. 18%, 100% respectively. The predictive sensitivity,specificity and negative predictive value of writhing movements CS for motor retardation and cerebral palsy were 100%,95. 81%,100% and 100%,95. 31% and 100%, respectively. Conclusion GMs quality assessment(writhing movements)has high reliability in predicting the motor development outcome of high-risk infants,especially cramped-synchronized has significant value in ear-ly screening of children with motor retardation and cerebral palsy.
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Objective@#To study the predictive value of general movements(GMs) quality assessment technique(writhing movements)on the motor development outcome of high-risk infants, so as to provide a reference basis for clinical diagnosis and treatment.@*Methods@#A retrospective analysis was made on the high-risk infants who were hospitalized in the Neonatal Department of the Affiliated Hospital of Inner Mongolia Medical University from January 1, 2017 to December 31, 2018, and the GMs quality assessment was finished and followed up to 12-month-old among high-risk infants.The clinical diagnostic criteria for patients with cerebral palsy and Peabody Development Motor Scales-2(PDMS-2)were used to evaluate the motor development outcome of 12-month-old high-risk infants.Furthermore, the predictive value of GMs writhing movements on the motor development outcome of high-risk infants were evaluated.@*Results@#The predictive validity of writhing movements phase[cramped synchronized(CS)+ poor repertoire(PR)]for motor retardation and cerebral palsy in high-risk infants who met the inclusion criteria were as follows: the sensitivity, specificity, positive predictive value, negative predictive value were 94.44%, 23.03%, 11.04%, 97.62% and 100%, 21.88%, 2.60%, 100%, respectively.The predictive sensitivity and negative predictive value of writhing movements PR for motor retardation and cerebral palsy were 92.31%, 100%; 98.18%, 100% respectively.The predictive sensitivity, specificity and negative predictive value of writhing movements CS for motor retardation and cerebral palsy were 100%, 95.81%, 100% and 100%, 95.31% and 100%, respectively.@*Conclusion@#GMs quality assessment(writhing movements)has high reliability in predicting the motor development outcome of high-risk infants, especially cramped-synchronized has significant value in early screening of children with motor retardation and cerebral palsy.
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Objective To compare the magnetic resonance imagings (MRI) of neonates diagnosed with cystic periventricular leukomalacia (cPVL) at different stages after birth , and to clarify the relationship of MRI and motor development outcomes.Method Data of neonates admitted to the Shengjing Hospital of China Medical Univerisity from January 2010 to May 2015 diagnosed with cPVL by MRI were studied retrospectively.Subjects were assigned into two groups according to time of diagnosis : early－diagnosed group (≤7 d) and late－diagnosed group (＞7 d).The MRI and subsequent motor development outcome were compared between two groups.Result There were 35 neonates in early－diagnosed group.The cysts were mainly located in the anterior horn of the lateral ventricle (35 infants), the body of the lateral ventricle (2 infants) and the centrum semiovale (1 infants).Only one cyst were found in 17 infants, two cysts in 14 infants, three or more cysts in 4 infants.There were 45 cases in the late－diagnosed group, the cysts were mainly located in the centrum semiovale ( 35 infants ) and the posterior horn of the lateral ventricle (34 infants), the body (20 infants) and the anterior horn (10 infants) of lateral ventricle.Only one cyst were found in 3 infants, two cysts in 5 infants, three or more cysts in 37 infants.Among the 23 infants in the early－diagnosed group with follow－up, 22 infants are clinically normal , one infant with spastic diplegia (4.3%).Among the 24 infants in the late－diagnosed group with followe－up, 4 infants are clinically normal , 20 infants with spastic hemiplegia , diplegia or quadriplegia (83.3%).There are significant differences of incidence of cerebral palsy between the two group (P＜0.05).Conclusion MRI imaging showed that the location, number of cysts are different between the early－diagnosed and late－diagnosed group, and the motor development outcome of the early－diagnosed group are better , which indicates the prognosis of cPVL that occurred in utero are better than acquired cPVL after birth.
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Objective@#To compare the predictive validity of writhing movements assessments of neurological outcome between high-risk preterm and full-term infants.@*Methods@#High-risk preterm and full-term infants who accepted the general movements(GMs) assessments from July 2013 to April 2014 and took part in follow-up regularly for 1 year in the Newborn Pediatrics Department of the Fifth Central Hospital of Tianjin were confirmed as the participants.GMs recordings during writhing movements period (at least once) and fidgety movements period (at least once) were collected and assessed.Neurological outcome was confirmed by Peabody Developmental Motor Scale-2(PDMS-2) when the patients were 1 year old.Then the predictive validities of writhing movements assessments of neurological outcome between high-risk preterm and full-term infants were calculated and compared.@*Results@#There was no significant difference in the detection rate of writhing movements between preterm and full-term infant groups(χ2=1.592, P=0.207). There was no significant difference in the detection rate of fidgety movements between preterm and full-term infant groups(χ2=1.605, P=0.205). The sensitivity was 92.9%, the specificity was 90.0%, and the negative predictive value was 97.8% in the stage of writhing movement to the motor development outcome in preterm infant group; the sensitivity was 85.7%, the specificity was 94.0%, and the negative predictive value was 95.9% in the stage of fidgety movement to the motor development outcome in preterm infant group; there was a good consistency between the assessment of writhing movement and neurological outcome confirmed by PDMS-2(Kappa=0.703, P<0.01). The specificity was 71.0%, the positive predictive value was 55.6% in the stage of writhing movement to the motor development outcome in full-term infant group; there was a worse consistency between the assessment of writhing movement and neurological outcome confirmed by PDMS-2(Kappa=0.555, P<0.01). Both the sensitivity and the specificity were 75.0% in the stage of writhing movement to the cerebral palsy in preterm infant group; there was a poor consistency between the assessment of writhing movement and neurological outcome confirmed by PDMS-2(Kappa=0.311, P<0.05). The specificity was 85.4%, the positive predictive value was 22.2% in the stage of writhing movement to the cerebral palsy in full-term infant group; there was still a poor consistency between the assessment of writhing movement and neurological outcome confirmed by PDMS-2(Kappa=0.319, P<0.05). Both the sensitivity and the negative predictive value were 100.0% in the stage of fidgety movement to the cerebral palsy in both preterm and full-term infant groups.@*Conclusions@#The predictive validity of writhing movements assessments to the motor development outcome in preterm infant group is higher than in full-term infant group, and it can be used as a tool for early and accurate prediction of neural development outcome of brain injured premature infants.The predictive validity of writhing movements assessments of the cerebral palsy is poor.Both the sensitivity and the negative predictive value were high in the stage of fidgety movement to the cerebral palsy in both preterm and full-term infant groups, and it may be used to predict the cerebral palsy earlier.