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Individual longitudinal neurodevelopmental trajectories of children treated with hypothermia for perinatal asphyxia from 3 months to 5 years of age.
Research in Developmental Disabilities ( IF 2.9 ) Pub Date : 2020-05-18 , DOI: 10.1016/j.ridd.2020.103659
Lieke Dekkers 1 , Anjo Janssen 2 , Katerina Steiner 3 , Nienke Maas-van Schaijk 4 , Reinier Akkermans 5 , Bert de Swart 1 , Maria Nijhuis-van der Sanden 6
Affiliation  

BACKGROUND Hypothermia for perinatal asphyxia is a common treatment to decrease morbidity. This study aims to describe a) individual longitudinal neurodevelopmental trajectories over 5 years in children with perinatal asphyxia treated with hypothermia and b) the correlation between movement quality at 3 months and motor developmental outcomes at 5 years of age. METHODS In this longitudinal cohort study, 18 children (12 male) were assessed at 3 (t1), 6 (t2), 12 (t3), and 24 (t4) months, and at the age of 5 (t5) years, with standardized norm-referenced tests. RESULTS Six children showed abnormal movement quality assessed with General Movements (t1) and all showed severe neurodevelopmental disabilities at t5. The 12 children without severe disabilities, showed a significant normalization of z-scores over the five assessment points (linear mixed model analysis). At t5, four of these children scored mildly delayed motor or cognitive development. CONCLUSION AND IMPLICATIONS Children without anomalies on the MRI before hospital discharge and normal movement quality at 3 months of age showed normal neurodevelopment at the age of 5, however, individual motor trajectories showed variability over time. Presents of abnormal GMs tend to detect CP and developmental problems, advocating a developmental surveillance to determine need for early intervention.

中文翻译:

3 个月至 5 岁围产期窒息接受低温治疗的儿童个体纵向神经发育轨迹。

背景 围产期窒息的低温治疗是降低发病率的常见治疗方法。本研究旨在描述 a) 接受低温治疗的围产期窒息儿童超过 5 年的个体纵向神经发育轨迹,以及 b) 3 个月时的运动质量与 5 岁时的运动发育结果之间的相关性。方法 在这项纵向队列研究中,18 名儿童(12 名男性)在 3 (t1)、6 (t2)、12 (t3) 和 24 (t4) 个月以及 5 (t5) 岁时接受评估,其中标准化的常模参照测试。结果 6 名儿童表现出通过一般运动 (t1) 评估的异常运动质量,并且在 t5 时均表现出严重的神经发育障碍。12名没有严重残疾的孩子,在五个评估点上显示了 z 分数的显着标准化(线性混合模型分析)。在 t5 时,其中 4 名儿童的运动或认知发育轻度延迟。结论和意义 出院前 MRI 无异常且 3 个月大时运动质量正常的儿童在 5 岁时神经发育正常,然而,个体运动轨迹随着时间的推移表现出变异性。异常 GM 的出现倾向于检测 CP 和发育问题,提倡进行发育监测以确定是否需要早期干预。结论和意义 出院前 MRI 无异常且 3 个月大时运动质量正常的儿童在 5 岁时神经发育正常,然而,个体运动轨迹随着时间的推移表现出变异性。异常 GM 的出现倾向于检测 CP 和发育问题,提倡进行发育监测以确定是否需要早期干预。结论和意义 出院前 MRI 无异常且 3 个月大时运动质量正常的儿童在 5 岁时神经发育正常,然而,个体运动轨迹随着时间的推移表现出变异性。异常 GM 的出现倾向于检测 CP 和发育问题,提倡进行发育监测以确定是否需要早期干预。
更新日期:2020-05-18
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