Analysis of the correlation between general movements assessment and NBNA results at twisting movement stage

doi:10.11852/zgetbjzz2019-0242

Abstract

Abstract: Objective To study the consistency between general movements (GMs) assessment and neonatal behavioral neurological assessment (NBNA) results in high-risk infants. Methods Totally 706 high-risk infants born in the Gansu Provincial Maternity and Childcare Hospital from January 2017 to January 2018 and followed up in Child Healthcare Department were enrolled in this study. All infants were assessed at twisting movement stage and finished NBNA neurological assessment. Kappa value of the two methods was calculated to analyze the consistency. Results The normal detection rate of GMs in full-term and normal birth weight infants was higher than that of premature and low birth weight infants (P＜0.05). And the detection rate of cramped-synchronized GMs in preterm infants was significantly higher than that in term infants (P=0.043). With the decrease of gestational age and birth weight, the detection rate of abnormal GMs presented an increasing trend significantly (P＜0.05). There were certain correlations between NBNA result and GMs assessment at different gestational age and birth weight groups, and the Kappa values were 0.112-0.289, 0.118-0.194 (P＜0.05). Conclusions The consistency of NBNA score and GMs assessment result at different gestational age and birth weight groups still needs to be further discussed. Moreover, the two methods cannot be replaced by each other. Combined application can evaluate the brain development of high-risk infants comprehensively, and promote their motor development and social adaptability.

Key words: high-risk infants, general movements assessment, neonatal behavioral neurological assessment

摘要： 目的对高危儿早期全身运动质量(GMs)评估法和新生儿行为神经测定(NBNA)方法的一致性进行分析。方法选取2017年1月-2018年1月甘肃省妇幼保健院出生在儿童保健科随访的有高危因素的患儿,选择完成GMs扭动阶段评估,并同时进行NBNA测评的研究对象共706例。分析2种评估方法的一致性Kappa值。结果足月、正常出生体重儿GMs评估正常检出率高于早产及低出生体重儿(P＜0.05)。早产患儿痉挛-同步性GMs检出率显著高于足月儿(P=0.043)。随着胎龄及出生体重的降低,异常的GMs检出率呈上升趋势,差异有统计学意义(P＜0.05)。不同出生胎龄及出生体重下NBNA评分与GMs评估有一定的相关性,Kappa值为0.112~0.289、0.118~0.194(P＜0.05)。结论不同出生胎龄及出生体重下NBNA评分与GMs评估的一致性有待于进一步探讨。两种方法相互不能取代,联合应用可更全面评价高危儿脑发育及脑损伤的情况,促进患儿的运动功能及社会适应性。

关键词: 高危儿, 全身运动质量评估, 新生儿行为神经测定

CLC Number:

R722.1

HUANG Lei, JIAO Xiao-yan, LI Jia-yue, HUI Ze-dong, JIN Bei-yi, HE Li. Analysis of the correlation between general movements assessment and NBNA results at twisting movement stage[J]. journal1, 2020, 28(3): 252-255.

黄蕾, 焦晓燕, 李佳樾, 惠泽栋, 金倍仪, 何莉. 扭动运动阶段全身运动评估与新生儿行为神经测定结果的相关分析[J]. 中国儿童保健杂志, 2020, 28(3): 252-255.

References

[1] Darsaklis V, Snider LM, Majnemer A, et al.Predictive validity of Prechtl′s method on the qualitative assessment of general movements: a systematic review of the evidence[J]. Dev Med Child Neurol,2011,53(10):896-906.
[2] Caravale B, Herich L, Zoia S, et al. Risk of developmental coordination disorder in Italian very preterm children at school agecompared to general population controls[J]. Eur J Paediatr Neurol, 2019,23(2):296-303.
[3] 尹欢欢,杨红. 全身运动评估在早产儿及小婴儿脑发育评估中的应用[J].中国实用儿科杂志,2017, 32(11): 816-820.
[4] 杨忠秀,朱萍,王雨晴,等. 全身运动质量评估在高危儿随访中的临床应用价值[J].中国儿童保健杂志,2012,20(9):847-849.
[5] van Iersel PA, Bakker SC, Jonker AJ, et al. Does general movements quality in term infants predict cerebral palsy and milder forms of limited mobility at 6 years?[J] Dev Med Child Neurol,2016, 58(12):1310-1316.
[6] 苏允鹏,杨红,史惟,等. 全身运动质量评估对足月脑损伤儿脑瘫发育结局的预测价值[J].中国儿童保健杂志,2014,22(7):680- 695.
[7] 陈楠,温晓红,黄金华,等.全身运动质量评估对窒息新生儿24月龄时不良结局的预测价值[J]. 中国当代儿科杂志,2015,17(12): 1322-1326.
[8] 曹艳华, 曹玉红.神经系统三种评估方法对高危儿脑损伤的评价比较[J].中国优生与遗传杂志,2013,21(2):1-10.
[9] 张晓燕,芦红茹,宋红霞,等. 20 项新生儿行为神经测定评分法对早产儿脑发育及脑损伤的评价[J]. 中国儿童保健杂志, 2010,18(2):159-162.
[10] 鲍秀兰,刘维民.新生儿行为神经测定和观察在早产儿及小婴儿脑发育评估和早期干预中的应用[J]. 中国实用儿科杂志, 2017,32(11):820-822.
[11] 宋国英,孟令丹,董荣芝,等. 早产儿全身运动质量评估与新生儿行为神经测定一致性研究[J].中国儿童保健杂志,2013,21(8): 842-844.
[12] 龚春丹,彭咏梅,马德军,等.高危儿童早期全身运动评估和脑电图分析[J].中国儿童保健杂志,2013,21(4):355- 357.
[13] 马良,孟令丹,郑春辉,等.影响婴儿全身运动质量的高危因素[J]. 中国当代儿科杂志,2014,16(9): 887-891.
[14] 李冬梅,郭志伟. 分娩胎龄和出生体重与全身运动质量相关性分析[J].中国妇幼保健,2014,29(10):1554-1556.
[15] 林星谷,林小苗,邹林霞,等.全身运动质量评估预测不同孕周早产高危儿神经发育结局的效度比较[J].中国康复理论与实践,2015,21(6):683-688.
[16] 孟令丹,马良,安新荣,等. 分娩胎龄和出生体重与不安运动的相关性分析[J]. 中国康复理论与实践,2013,19(7):669-670.
[17] Zang FF, Yang H, Han Q, et al. Very low birth weight infants in China: the predictive value of the motor repertoire at 3 to 5months for the motor performance at 12months[J]. Early Hum Dev,2016, 100:27-32.
[18] 鲍克秀,王雨晴,杨忠秀. 全身运动质量评估与神经运动检查法评估康复科患儿早期中枢神经系统发育情况的价值比较[J].中国医药导报, 2014, 11(13): 151-153.
[19] 李洪华,单玲,王冰,等. 运动识别技术在评估早产儿自发性全身运动中的应用[J]. 中国当代儿科杂志,2017,19(12):1306-1310.