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目的评估高危新生儿不安运动(FMs)对运动发育结局的早期预测价值。方法随访高危新生儿39例,矫正日龄6～20周记录FMs,10～18月进行Gesell发育量表或丹佛发育筛查量表评估,结合婴儿神经系统检查确定发育结局。结果FMs正常的33例中随访诊断运动发育迟缓1例;未出现FMs的6例中,随访诊断脑性瘫痪4例,全面发育迟缓2例。FMs评估预测脑性瘫痪敏感度为100%,特异度为94%,阳性预测值为67%,阴性预测值为100%。预测运动发育迟缓的敏感度为86%,特异度为100%,阳性预测值为100%,阴性预测值为97%。结论FMs缺乏是早期预测脑性瘫痪良好而可靠的指标。矫正年龄10～14周单次FMs评估对运动发育也具有良好的预测价值,但对脑性瘫痪的阳性预测值较低。
Objective To assess the early predictive value of high-risk neonatal unrest (FMs) on motor outcome. Methods Thirty-nine high-risk neonates were followed up. FMs were recorded from 6 to 20 weeks after correction. Gesell’s developmental scale or Denver Developmental Screening Scale was used from October to August. The developmental outcomes were determined by neurological examination. Results Among the 33 cases with normal FMs, 1 case was diagnosed as delayed motor development. Among the 6 cases without FMs, 4 cases were diagnosed as cerebral palsy and 2 cases were fully developed. The FMs assessment predicts cerebral palsy with a sensitivity of 100%, a specificity of 94%, a positive predictive value of 67%, and a negative predictive value of 100%. The sensitivity of predicting motor stunting was 86% with a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 97%. Conclusion The lack of FMs is a good and reliable predictor of cerebral palsy in the early stage. A single FMs assessment of corrected age 10-14 weeks also had good predictive value for motor development, but a lower positive predictive value for cerebral palsy.