L Ma, LD Meng, YH Chen, MJ Yi, JW Wang, AH Cao

Abstract

Background: The quality of general movements assessment, used to assess individual infant from birth to 20 weeks of age, has emerged as one of the most reliable and valid predictors of severe neurological impairments. Aim: To investigate the risk factors for the quality of general movements, which is a predictive value for brain dysfunction in infants. Method: 618 cases at the stage of writhing movements and 539 cases at the stage of fidgety movements were selected for assessment of the quality of general movements. The risk factors for the quality of general movements in infants were analysed by ANOVA, chi-square test, and multivariate logistic regression. Results: Multivariate logistic regression analysis showed that the factors that were significantly correlated with the quality of general movements at the stage of writhing movements included delivery gestational age (OR=0.762, P<0.001), birth weight (OR=0.264, P<0.001), severe asphyxia (OR=2.445, P=0.012), and intrauterine distress (OR=4.865, P<0.001). The factors that were significantly correlated with the quality of general movements at the stage of fidgety movements were delivery gestational age (OR=0.786, P=0.003), birth weight (OR=0.217, P<0.001), severe asphyxia (OR=3.765, P=0.001), and hyperbilirubinaemia (OR=2.640, P=0.028). Conclusions: Low delivery gestational age, low birth weight, severe asphyxia, hyperbilirubinaemia and intrauterine distress are risk factors and predictors for abnormal general movements in infants.

背景：嬰兒整體動作質量的評估，用於對出生後至20週齡嬰兒的個體評估，已成為嚴重神經損傷的最可靠和有用的預測指標之一。目的：探索嬰兒整體動作質量的高危因素，對於嬰兒腦功能不全具有預測價值。方法：選取處於扭動動作狀態嬰兒618例，煩躁不安動作狀態嬰兒539例，納入整體動作品質評估。對嬰兒整體動作的高風險因素進行ANOVA分析、卡方測驗、和多變數邏輯回歸分析。結果：多變數邏輯回歸分析顯示，扭動動作狀態嬰兒整體動作品質的影響因素包括：分娩孕週（OR=0.762, P<0.001），出生體重（OR=0.264, P<0.001），嚴重窒息（OR=2.445, P=0.012），和宮內窘迫（OR=4.865, P<0.001）。煩躁不安動作狀態嬰兒整體動作品質的影響因素包括：分娩孕週（OR=0.786, P=0.003），出生體重（OR=0.217, P<0.001），嚴重窒息（OR=3.765, P=0.001），和高血紅蛋白血症（OR=2.640, P=0.028）。結論：分娩孕週小、出生體重低、嚴重窒息、宮內窘迫及高血紅蛋白血症，都是嬰兒整體動作異常的高風險因素和預測指標。