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Psychometric properties of functional postural control tests in children: A systematic review

ANNALS OF PHYSICAL AND REHABILITATION MEDICINE 2023年第4期66卷 101729-101729页

作者： Johnson, Charlotte Hallemans, Ann Goetschalckx, Mieke Meyns, Pieter Rameckers, Eugene Klingels, Katrijn Verbecque, Evi Univ Antwerp Dept Rehabil Sci & Physiotherapy REVAKI Res Grp MOVANT B-2610 Antwerp Belgium Hasselt Univ Fac Rehabil Sci & Physiotherapy Rehabil Res Ctr REVAL B-3590 Diepenbeek Belgium Maastricht Univ Res Sch CAPHRI Dept Rehabil Med NL-6229 Maastricht Netherlands Ctr Expertise Adelante Rehabil NL-6301 KA Valkenburg Netherlands Universiteitsplein 1 B-2610 Antwerp Belgium

Background: Postural control deficits are one of the most common impairments treated in pediatric physiothera-peutic practice. Adequate evaluation of these deficits is imperative to identify postural control deficits, plan treat-ment and assess efficacy. Currently, there is no gold standard evaluation for postural control deficits. However, the number of studies investigating the psychometric properties of functional pediatric postural control tests has increased ***: To facilitate the selection of an appropriate pediatric functional postural control test in research and clinical practice. Methods: systematic review following the PRISMA guidelines. PubMed, Web of Science and Scopus were sys-tematically searched (last update: June 2022;PROSPERO: CRD42021246995). Studies were selected using the PICOs-method (pediatric populations (P), functional assessment tools for postural control (I) and psycho-metric properties (O). The risk of bias was rated with the COSMIN checklist and the level of evidence was determined with GRADE. For each test, the postural control systems were mapped, and the psychometric properties were ***: Seventy studies investigating 26 different postural control tests were included. Most children were healthy or had cerebral palsy. Overall, the evidence for all measurement properties was low to very low. Most tests (95%) showed good reliability (ICC>0.70), but inconsistent validity results. Structural validity, internal consistency and responsiveness were only available for 3 tests. Only the Kids-BESTest and FAB cov-ered all postural control ***: Currently, 2 functional tests encompass the entire construct of postural control. Although reliabil-ity is overall good, validity results depend on task, age and pathology. Future research should focus on test batteries and should particularly explore structural validity and responsiveness in different populations with methodologically strong study designs.(c)

关键词： APA Anticipatory postural adjustments BBS Berg Balance Scale BBW Balance Beam Walking BESS Balance Error Scoring system BESTest Balance Evaluation systems Test BOT-2 Bruininks-Oseretsky Test for motor pProficiency, 2nd edition CB&M Community Balance & Mobility Scale CGT Complex Gait Test COSMIN COnsensus-based Standard for the selection of health Measurement Instruments CP Cerebral palsy (m)CT-SIB (Modified) Clinical Test of Sensory Interaction in Balance DGI Dynamic Gait Index ECAB Early Clinical Assessment of Balance FAB Fullerton Advanced Balance Scale FRT Forward Reach Test FSST Four Square Step Test GAS Goal Attainment Scale GDBT Ghent Developmental Balance Test GMFCS gross motor function classification system GMFM-66/88 gross motor function Measure with 66/88 items GRADE Grading of Recommendations Assessment, Development and Evaluation ICC Intraclass correlation coefficient ICF International classification of functioning, Disability and Health Kids-BESTest Kids-Balance Evaluation systems Test Kw Wweighted kappa LoE Level of Evidence LRT Lateral Reach Test MABC(-2) Movement Assessment Battery for Cchildren (2nd edition) MABC(-2) B Balance domain MCID Minimal clinically important difference MRT Multidirectional Reach Test OLS One-Leg-Stance PBS Pediatric Balance Scale PDMS-2 Peabody Developmental motor Scales, 2nd edition PDMS-2 L/S Llocomotion domain stationary domain PEDI Pediatric Evaluation Disability Inventory PRISMA Preferred Reporting Items for systematic Review and Meta-Analyses PRT Pediatric Reach Test RT Reach Tests SBST Stork Balance Stand Test SEBT Star Excursion Balance Test SEM Standard error of measurement SRM Standardized response mean SOT Sensory Organization Test SWOC Standardized Walking Obstacle Course TDC Typically developing children TS Tandem-Stance TUDS Timed Up and Down Stairs test TUG Timed Up and Go test YBT Y-Balance Test

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Trends in Gestational Age-Related Intelligence Outcomes of School-Age Children Born Very Preterm from 2001 to 2015 in Taiwan

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JOURNAL OF PEDIATRICS 2023年 261卷 1-10页

作者： Wang, Lan-Wan Chu, Chi-Hsiang Lin, Yung-Chieh Huang, Chao-Ching Chi Mei Med Ctr Dept Pediat Tainan Taiwan Southern Taiwan Univ Sci & Technol Dept Biotechnol & Food Technol Tainan Taiwan Tunghai Univ Dept Stat Taichung Taiwan Natl Cheng Kung Univ Natl Cheng Kung Univ Hosp Coll Med Dept Pediat Tainan Taiwan Taipei Med Univ Coll Med Dept Pediat Taipei Taiwan

Objective To investigate whether gestational age (GA)-related intelligence outcomes of children born very pre-term improved over time. Study design A multicenter cohort study recruited 4717 infants born at GA <31 weeks and admitted to neonatal intensive care units between 2001 and 2015 in Taiwan. Intelligence outcomes at age 5.5 years were classified by intelligent quotient (IQ) into no cognitive impairment (IQ > -1 SD), mild cognitive impairment (IQ = -1 similar to-2 SD), and moderate/severe cognitive impairment (IQ < -2 SD). Trends were assessed for neonatal morbidities, mortality, and intelligence outcomes by birth epoch (2001-2003, 2004-2006, 2007-2009, 2010-2012, 2013-2015) and GA (23-24, 25-26, 27-28, 29-30 weeks). Results Maternal education levels increased and rates of brain injury and mortality decreased over time. Among the 2606 children who received IQ tests, the rates of no, mild, and moderate/severe cognitive impairment were 54.5%, 30.5%, and 15.0%, respectively. There were significant trends in the increasing rates of no cognitive impairment and declining rates of mild and moderate/severe cognitive impairment in all GA groups across the 5 birth epochs. Relative to the occurrence in 2001-2003, the odds were significantly reduced for moderate/severe cognitive impairment from 2007-2009 (aOR 0.49, 95% CI 0.30-0.81) to 2013-2015 (0.35, 0.21-0.56) and for mild cognitive impairment from 2010-2012 (0.54, 0.36-0.79) to 2013-2015 (0.36, 0.24-0.53). Conclusions For children born very preterm between 2001 and 2015 in Taiwan, the improvement of maternal education levels and improvements in neonatal brain injury and mortality were temporally associated with trends of decreasing intellectual impairment at school age across all GA groups.

关键词： gestational age IQ preterm children BPD Bronchopulmonary dysplasia CP Cerebral palsy cPVL Cystic periventricular leukomalacia FSIQ Full-scale IQ GA Gestational age GMFCS gross motor function classification system IQ Intelligence quotient IVH Intraventricular hemorrhage NEC Necrotizing enterocolitis ROP Retinopathy of prematurity SGA Small for gestational age WPPSI-IV Wechsler Preschool and Primary Scale of Intelligence–Fourth Edition WPPSI-R Wechsler Preschool and Primary Scale of Intelligence–Revised

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Severe Congenital Heart Defects and Cerebral Palsy

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JOURNAL OF PEDIATRICS 2023年 262卷 113617-113617页

作者： Garne, Ester Goldsmith, Shona Barisic, Ingeborg Braz, Paula Dakovic, Ivana Gibson, Catherine Hansen, Michele Hoei-Hansen, Christina E. Hollung, Sandra Julsen Klungsoyr, Kari Smithers-Sheedy, Hayley Virella, Daniel Badawi, Nadia Watson, Linda McIntyre, Sarah Univ Hosp Southern Denmark Lillebaelt Hosp Dept Pediat & Adolescent Med Kolding Denmark Univ Sydney Sydney Med Sch Cerebral Palsy Alliance Res Inst Fac Med & HlthSpecial Child & Adolescent Hlth Sydney NSW Australia Univ Zagreb Childrens Hosp Zagreb Ctr Excellence Reprod & Regenerat Med Med Sch Zagreb Croatia Natl Hlth Inst Dr Richardo Jorge Dept Epidemiol Natl Registry Congenital Anomalies Lisbon Portugal Univ Zagreb Childrens Hosp Med Sch Zagreb Croatia Womens & Childrens Hosp South Australian Birth Defects Register Womens & Childrens Hlth Network Adelaide SA Australia Western Australian Register Dev Anomalies Dept Hlth Western Australia Perth Australia Univ Western Australia Telethon Kids Inst Perth WA Australia Univ Hosp Rigshospitalet Univ Copenhagen Dept Pediat Copenhagen Denmark Univ Copenhagen Dept Clin Med Copenhagen Denmark Vestfold Hosp Trust Norwegian Qual & Surveillance Registry Cerebral Pa Tonsberg Norway Univ Bergen Dept Global Publ Hlth & Primary Care Bergen Norway Norwegian Inst Publ Hlth Div Mental & Phys Hlth Bergen Norway Natl Hlth Inst Dr Richardo Jorge Dept Epidemiol Natl Registry Surveillance Cerebral Palsy Lisbon Portugal Childrens Hosp Westmead Grace Ctr Newborn Intens Care Sydney Australia

Objective To report the prevalence of cerebral palsy (CP) in children with severe congenital heart defects (sCHD) and the outcome/severity of the CP. Methods Population-based, data linkage study between CP and congenital anomaly registers in Europe and Australia. The EUROCAT definition of severe CHD (sCHD) was used. Linked data from 4 regions in Europe and 2 in Australia were included. All children born in the regions from 1991 through 2009 diagnosed with CP and/or sCHD were included. Linkage was completed locally. Deidentified linked data were pooled for analyses. Results The study sample included 4989 children with CP and 3684 children with sCHD. The total number of live-births in the population was 1 734 612. The prevalence of CP was 2.9 per 1000 births (95% CI, 2.8-3.0) and the prevalence of sCHD was 2.1 per 1000 births (95% CI, 2.1-2.2). Of children with sCHD, 1.5% (n = 57) had a diagnosis of CP, of which 35 (61%) children had prenatally or perinatally acquired CP (resulting from a brain injury at <= 28 days of life) and 22 (39%) children had a postneonatal cause (a brain injury between 28 days and 2 years). Children with CP and sCHD more often had unilateral spastic CP and more intellectual impairments than children with CP without congenital anomalies. Conclusions In high-income countries, the proportion of children with CP is much higher in children with sCHD than in the background population. The severity of disease in children with CP and sCHD is milder compared with children with CP without congenital anomalies.

关键词： cerebral palsy CHD brain injury intellectual impairment severity CHD Congenital heart defect CP Cerebral palsy EUROCAT European Network for Surveillance of Congenital Anomalies GMFCS gross motor function classification system sCHD Severe congenital heart defect

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Evaluation of autonomic nervous system in children with spastic cerebral palsy: clinical and electophysiological study

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EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021年第1期48卷 1-9页

作者： Azouz, Hanan G. AbdelMohsen, Ali M. Abdel Ghany, Hayam M. Mohamed, Rana M. Alexandria Univ Dept Pediat Fac Med Alexandria 21321 Egypt Alexandria Univ Fac Med Phys Med Rheumatol & Rehabil Dept Alexandria 21321 Egypt

Background Cerebral palsy (CP) is the most prevalent severe motor disability among children. The aim of this work was to assess autonomic dysfunction in children with cerebral palsy clinically and electrophysiologically. Results Age of the studied children ranged from 4 to 12 years. Quadriplegic type of spastic cerebral palsy constituted 82.5% of CP children while diplegic type constituted 17.5%. Based on gross motor function classification system (GMFCS), the majority of children were in levels 4 and 5. The prevalence of autonomic dysfunction symptoms were 80% for thermoregulatory abnormalities (cold extremities), 65% for chronic constipation, 52.5% for sleep disturbance, 47.5% for loss of appetite, 40% for sweating abnormalities, 25% for recurrent nausea and/or vomiting, 22.5% for increased sensitivity to light or dark and 15% for bloating. As regards sympathetic skin response, 19 CP children had unobtainable response in both upper and lower limbs while 5 children had unobtainable response in lower limbs only. All of them were in levels 4 and 5 of GMFCS. Postural hypotension was present in 20% of CP children. Mean Heart rate of CP children was significantly increased more than healthy children upon head tilt test. Conclusions Autonomic dysfunction has been objectively proven in CP children through absent sympathetic skin response, presence of orthostatic tachycardia and postural hypotension.

关键词： Cerebral palsy Sympathetic skin response Heart rate gross motor function classification system

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Evaluating Completeness of Discrete Data on Physical functioning for Children With Cerebral Palsy in a Pediatric Rehabilitation Learning Health system

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PHYSICAL THERAPY 2022年第1期102卷 pzab234页

作者： Koscielniak, Nikolas J. Tucker, Carole A. Grogan-Kaylor, Andrew Friedman, Charles P. Richesson, Rachel Tucker, Josh S. Piatt, Gretchen A. Wake Forest Univ Bowman Gray Sch Med Clin & Translat Sci Inst Winston Salem NC 27101 USA Temple Univ Coll Publ Hlth Sci Philadelphia PA USA Univ Michigan Sch Social Work Ann Arbor MI 48109 USA Univ Michigan Dept Learning Hlth Sci Ann Arbor MI USA Childrens Hosp Philadelphia Dept Pediat & Biomed & Hlth Informat Philadelphia PA USA

Objective The purpose of this study was to determine the extent that physical function discrete data elements (DDE) documented in electronic health records (EHR) are complete within pediatric rehabilitation settings. Methods A descriptive analysis on completeness of EHR-based DDEs detailing physical functioning for children with cerebral palsy was conducted. Data from an existing pediatric rehabilitation research learning health system data network, consisting of EHR data from 20 care sites in a pediatric specialty health care system, were leveraged. Completeness was calculated for unique data elements, unique outpatient visits, and unique outpatient records. Results Completeness of physical function DDEs was low across 5766 outpatient records (10.5%, approximately 2 DDEs documented). The DDE for gross motor function classification system level was available for 21% (n = 3746) outpatient visits and 38% of patient records. Ambulation level was the most frequently documented DDE. Intercept only mixed effects models demonstrated that 21.4% and 45% of the variance in completeness for DDEs and the gross motor function classification system, respectively, across unique patient records could be attributed to factors at the individual care site level. Conclusion Values of physical function DDEs are missing in designated fields of the EHR infrastructure for pediatric rehabilitation providers. Although completeness appears limited for these DDEs, our observations indicate that data are not missing at random and may be influenced by system-level standards in clinical documentation practices between providers and factors specific to individual care sites. The extent of missing data has significant implications for pediatric rehabilitation quality measurement. More research is needed to understand why discrete data are missing in EHRs and to further elucidate the professional and system-level factors that influence completeness and missingness. Impact Completeness of DDEs report

关键词： Electronic Health Records gross motor function classification system Learning Health systems Pediatric Rehabilitation

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Neuroprotection for hypoxic-ischemic encephalopathy: Contributions from the neonatal research network

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SEMINARS IN PERINATOLOGY 2022年第7期46卷 151639-151639页

作者： Bonifacio, Sonia Lomeli Chalak, Lina F. Van Meurs, Krisa P. Laptook, Abbot R. Shankaran, Seetha Stanford Univ Dept Pediat Sch Med Div Neonatal & Dev Med Palo Alto CA 94304 USA Univ Texas Southwestern Med Ctr Dallas Div Neonatal Perinatal Med Dallas TX USA Women & Infants Hosp Rhode Isl Dept Pediat Providence RI USA Wayne State Univ Dept Pediat Detroit MI 48202 USA

Therapeutic hypothermia (TH) is now well established as the standard of care treatment for moderate to severe neonatal encephalopathy secondary to perinatal hypoxic ischemic encephalopathy (HIE) in infants >36 weeks gestation in high income countries. The Neonatal Research Network (NRN) contributed greatly to the study of TH as a neuroprotectant with three trials now completed in infants >= 36 weeks gestation and the only large randomized-controlled trial of TH in preterm infants now in the follow-up phase. Data from the first NRN TH trial combined with data from other large trials of TH affirm the safety and neuroprotective qualities of TH and highlight the importance of providing TH to all infants who qualify. In this review we will highlight the findings of the three NRN trials of TH in the term infant population and the secondary analyses that continue to inform the care of patients with HIE. (C) 2022 Published by Elsevier Inc.

关键词： aEEG Amplitude integrated electroencephalogram ALIC Anterior limb of the internal capsule BGT Basal ganglia/thalamus cEEG Continuous electroencephalogram CI Confidence interval CP Cerebral palsy EEG Electroencephalogram EPO Erythropoietin FSIQ Full scale intelligence quotient GMFCS gross motor function classification system HEAL High-dose Erythropoietin for Asphyxia and Encephalopathy HIE Hypoxic ischemic encephalopathy HIC High income country ICE Infant Cooling Evaluation trial IQ Intelligence quotient HIE Hypoxic-ischemic encephalopathy LMIC Low-middle income country MDI Mental developmental index MRI Magnetic resonance imaging NCT ClinicalTrials.gov Identifier NEPSY NEuroPSYchological assessment NICHD Eunice Kennedy Shriver National Institute of Child Health and Human Development NRN Neonatal Research Network OC Optimizing Cooling trial PCO 2 Partial pressure of carbon dioxide PPHN Persistent pulmonary hypertension of the newborn PLIC Posterior limb of the internal capsule RCT Randomized controlled trial SA Sedation-analgesia Tes Esophageal temperature TH Therapeutic hypothermia TOBY Total Body Hypothermia trial WeeFIM functional Independence Measures for Children WM White matter WS Watershed

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Early neurodevelopmental follow-up in the NICHD neonatal research network: Advancing neonatal care and outcomes, opportunities for the future

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SEMINARS IN PERINATOLOGY 2022年第7期46卷 151642-151642页

作者： Kilbride, Howard W. Vohr, Betty R. McGowan, Elisabeth M. Peralta-Carcelen, Myriam Stringer, Kimberlly Das, Abhik Archer, Stephanie Wilson Hintz, Susan R. Childrens Mercy Kansas City Dept Pediat 2401 Gillham Rd3rd Floor Annex Kansas City MO 64108 USA Univ Missouri 2401 Gillham Rd3rd Floor Annex Kansas City MO 64110 USA Women & Infants Hosp Rhode Isl Dept Pediat Providence RI USA Brown Univ Providence RI 02912 USA Univ Alabama Birmingham Div Neonatol Birmingham AL USA RTI Int Social Stat & Environm Sci Unit Rockville MD USA Eunice Kennedy Shriver Natl Inst Child Hlth & Hum Bethesda MD USA Stanford Univ Dept Pediat Sch Med Palo Alto CA USA

At the inception of the Eunice Kennedy Shriver National Institute of Child Health and Development Neonatal Research Network (NRN), provision of care for extremely preterm (EPT) infants was considered experimental. The NRN Follow-up Study Group, initiated in 1993, developed infrastructure with certification processes and standards, allowing the NRN to assess 2-year outcomes for EPT and to provide important metrics for randomized clinical trials. This chapter will review the NRN Follow-up Study Group's contributions to understanding factors related to improved neurodevelopmental, behavioral, and social-emotional outcomes of EPT infants. We will also discuss follow up challenges, including reassessing which outcomes are most meaningful for parents and investigators. Finally, we will explore how outcome studies have informed clinical decisions and ethical considerations, given limitations of prediction of complex later childhood outcomes from early neurodevelopmental findings. (C) 2022 Elsevier Inc. All rights reserved.

关键词： ACES Adverse Childhood Experiences ADHD Attention deficit hyperactivity disorder aOR Adjusted odds ratio ASD Autism spectrum disorder ASQ-SE Ages and Stages Questionnaire for Social-Emotional BPD Bronchopulmonary dysplasia BW Birthweight CA Corrected age CBCL Child Behavioral Checklist CI Confidence interval CP Cerebral palsy CPS Child Protective Services ELBW Extremely low birthweight EPT Extremely preterm GA Gestational age GDB Generic Database GMFCS gross motor function classification system IP Intestinal perforation IVH Intraventricular hemorrhage LBW Low birthweight MDI Mental Developmental Index ND Neurodevelopmental NDI Neurodevelopmental impairment NEC Necrotizing enterocolitis NICHD Eunice Kennedy Shriver National Institute of Child Health and Development NIDD Neurologic impairment or developmental delay NRN Neonatal Research Network RCT Randomized controlled trial SUPPORT Surfactant Positive Airway Pressure and Pulse Oximetry Trial TOP Transfusion of Prematures trial VLBW Very low birth weight VON Vermont Oxford Network

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Perinatal management: Lessons learned from the neonatal research network

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SEMINARS IN PERINATOLOGY 2022年第7期46卷 151636-151636页

作者： Ramachandran, Shalini Foglia, Elizabeth E. DeMauro, Sara B. Chawla, Sanjay Brion, Luc P. Wyckoff, Myra H. Univ Texas Southwestern Med Ctr Dallas Dept Pediat Dallas TX 75390 USA Univ Penn Dept Pediat Perelman Sch Med Philadelphia PA 19104 USA Wayne State Univ Dept Pediat Cent Michigan Univ Childrens Hosp Michigan Detroit MI USA

Recent contributions of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) regarding obstetrical perinatal interventions and neonatal delivery room practices include the following: the impact of multiple antepartum factors including maternal diabetes, hypertension, obesity and mode of delivery on outcomes of extremely preterm newborns, effects of delayed delivery interval for extremely preterm multiples, effects of antenatal steroids on preterm newborn outcomes and the impact of antenatal magnesium sulfate therapy on neurodevelopmental outcomes for extremely preterm infants. NRN studies also contribute important evidence for neonatal delivery room resuscitation guidelines including umbilical cord management and maintenance of euthermia immediately after birth. The updated NRN outcome calculator helps better counsel families regarding possible outcomes for the most immature newborns if resuscitation is attempted at birth. Thus, the NRN provides substantial information regarding effects of perinatal management on newborn infants. (C) 2022 Elsevier Inc. All rights reserved.

关键词： ANS Antenatal corticosteroids aOR Adjusted odds ratio ARR Adjusted relative risk BITSEA Brief Infant Social Emotional Assessment BMI Body mass index BPD Bronchopulmonary dysplasia BSID-III Bayley Scales of Infant Development-III CI Confidence interval CPAP Continuous positive airway pressure cPVL Cystic periventricular leukomalacia DR Delivery room EPT Extreme preterm GA Gestational age GDB Generic Database study GMFCS gross motor function classification system ICH Intracranial hemorrhage MPT Moderate preterm infants NEC Necrotizing enterocolitis NICHD Eunice Kennedy Shriver National Institute of Child Health and Human Development NICU Neonatal intensive care unit NDI Neurodevelopmental impairment NRN Neonatal Research Network OR Odds ratio RCT Randomized controlled trial ROP Retinopathy of prematurity SGA Small for gestational age SUPPORT Surfactant, Positive Pressure, and Oxygenation Randomized Trial VON Vermont-Oxford Neonatal Network

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Neurodevelopmental Outcomes of Infants at <29 Weeks of Gestation Born in Canada Between 2009 and 2016

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JOURNAL OF PEDIATRICS 2022年 247卷 60-+页

作者： Ricci, M. Florencia Shah, Prakesh S. Moddemann, Diane Alvaro, Ruben Ng, Eugene Lee, Shoo K. Synnes, Anne Univ Manitoba Dept Pediat & Child Hlth 1155 Notre Dame Ave Winnipeg MB R3E 3G1 Canada Univ Toronto Dept Pediat Toronto ON Canada Sunnybrook Hlth Sci Ctr Newborn & Dev Pediat Toronto ON Canada Univ Toronto Dept Obstet & Gynecol Toronto ON Canada Univ British Columbia Dept Pediat Vancouver BC Canada

Objective To evaluate changes in mortality or significant neurodevelopmental impairment (NDI) in children born at 20 (31% vs 35%) and late-onset sepsis (23% vs 27%). Death or significant NDI occurred in 30% of childre... 详细信息

Objective To evaluate changes in mortality or significant neurodevelopmental impairment (NDI) in children born at <29 weeks of gestation in association with national quality improvement initiatives. Study design This longitudinal cohort study included children born at 220/7 to 286/7 weeks of gestation who were admitted to Canadian neonatal intensive care units between 2009 and 2016. The primary outcome was a composite rate of death or significant NDI (Bayley Scales of Infant and Toddler Development, Third Edition score <70, severe cerebral palsy, blindness, or deafness requiring amplification) at 18-24 months corrected age. To evaluate temporal changes, outcomes were compared between epoch 1 (2009-2012) and epoch 2 (2013-2016). aORs were calculated for differences between the 2 epochs accounting for differences in patient characteristics. Results The 4426 children included 1895 (43%) born in epoch 1 and 2531 (57%) born in epoch 2. Compared with epoch 1, in epoch 2 more mothers received magnesium sulfate (56% vs 28%), antibiotics (69% vs 65%), and delayed cord clamping (37% vs 31%) and fewer infants had a Score for Neonatal Acute Physiology, version II >20 (31% vs 35%) and late-onset sepsis (23% vs 27%). Death or significant NDI occurred in 30% of children in epoch 2 versus 32% of children in epoch 1 (aOR, 0.86;95% CI, 0.75-0.99). In epoch 2, there were reductions in the need for hearing aids or cochlear implants (1.4% vs 2.6%;aOR, 0.50;95% CI, 0.31-0.82) and in blindness (0.6% vs.1.4%;aOR, 0.38;95% CI, 0.18-0.80). Conclusions Among preterm infants born at <29 weeks of gestation, composite rates of death or significant NDI and rates of visual and hearing impairment were significantly lower in 2013-2016 compared with 2009-2012.

关键词： development preterm impairment Bayley III Bayley Scales of Infant and Toddler Development, Third Edition BPD Bronchopulmonary dysplasia CA Corrected age CNFUN Canadian Neonatal Follow-Up Network CNN Canadian Neonatal Network CP Cerebral palsy EPIQ Evidence-Based Practice for Improving Quality GMFCS gross motor function classification system NDI Neurodevelopmental impairment NEC Necrotizing enterocolitis NICU Neonatal intensive care unit ROP Retinopathy of prematurity SNAP-II Score for Neonatal Acute Physiology, Version II

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Cognitive, academic, executive and psychological functioning in children with spastic motor type cerebral palsy: Influence of extent, location, and laterality of brain lesions

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EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY 2022年 38卷 A1-A1页

作者： Vermeulen, R. Jeroen Maastricht Univ Med Ctr Sch Mental Hlth & Neurosci Maastricht Netherlands

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