Infanib对新生儿重症监护病房出院早产儿早期运动发育及预后评估

Infant Neurological International Battery predicts neurological outcomes of preterm infants discharged from the neonatal intensive care unit

摘要:

目的：探讨 Infant Neurological International Battery (Infanib)对新生儿重症监护病房出院的高危早产儿后期运动发育异常的预测效度。方法：纳入对象为 2008年6月至2010年3月入住新生儿重症监护病房治疗出院的早产儿，在纠正年龄3~4月、6~7月龄时采用 Infanib 进行运动发育评估；在纠正年龄12月龄或12月龄以上采用 Peabody 运动发育量表或临床神经学体检评估运动结局。通过计算 Infanib 对后期运动发育结局评估的敏感性、特异性、阳性预测值以及阴性预测值等进行预测效度评价。结果：共147例早产儿参与临床随访，在纠正年龄3~4月、6~7月龄时进行 Infanib 评估的患儿分别为147例、117例；纠正年龄12月龄或12月龄以上 129例。最终运动发育正常90例(69.8％)，运动发育落后 28例(21.7％)，脑瘫 11例(8.5％)。纠正年龄3~4月龄和6~7月龄 Infanib评估对运动发育异常的敏感性分别为84.6％、100％；特异性75.6％、91.7％；阳性预测值60.0％、82.5％；阴性预测值91.9%、100％。结论：Infanib 可以用于早产儿运动发育的早期评估，并具有较好的预测效度。

Abstract:

OBJECTIVE: To explore the Infant Neurological International Battery (Infanib) as a screening tool for early detection of gross motor developmental delay in preterm infants discharged from NICU, and to predict their later neuromotor dysfunction (cerebral palsy or motor retardation). METHODS: A cohort of preterm infants who were admitted to the neonatal intensive care unit between June 2008 and March 2010 were enrolled in the study. Infanib assessment was performed at corrected age 3-4 months and 6-7 months. Peabody Developmental Motor scale-2 (PDMS-2) and neuro-examinations were used to confirm the last motor retardation. The sensitivity, specificity, positive predictive value and negative predictive value of the Infanib were calculated.ResultsA total of 147 preterm infants were participated in this study, and 129 infants were followed up at correct age 12 months or more than 12 months. Eleven (8.5%) had crerbral palsy, 28 (21.7%) had motor retardation, and 90 (69.8%) normal mortor development. The predictive validity of the Infanib at correct age 3-4 months (n=14) was: sensitivity 84.6%, specificity 75.6%, positive predictive value 60.0% and negative predictive value 91.9%. The predictive validity of the Infanib at correct age 6-7 months (n=117) was: sensitivity 100%, specificity 91.7%, positive predictive value 82.5% and negative predictive value 100%. CONCLUSIONS: The Infanib can be used as an appropriate screening tool and validity measurement for early detection of gross motor developmental delay in preterm infants.