新生儿先天性胃肠道畸形的全身运动评估：单中心回顾性研究-动脉网

General movement assessments in neonates born with congenital gastrointestinal anomalies: a single site, retrospective study

Nature 等信源发布 2025-02-21 12:05

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Abstract

摘要

Objective

目标

We aimed to characterize general movements in neonates with congenital gastrointestinal anomalies and to compare them to general movements in extremely low birth weight (ELBW) infants.

我们旨在描述患有先天性胃肠道畸形的新生儿的一般运动，并将其与极低出生体重（ELBW）婴儿的一般运动进行比较。

Study design

研究设计

This was a retrospective, single-site study. Subjects were divided into two groups: those with gastrointestinal (GI) anomalies and ELBW infants (birth weight <1 kg). The primary outcome was general movement assessments.

这是一项回顾性、单中心研究。受试者分为两组：一组是患有胃肠道（GI）异常的婴儿，另一组是极低出生体重（ELBW）婴儿（出生体重<1公斤）。主要结局指标是全身运动评估。

Result

结果

Ninety-six infants were included (

包括了九十六名婴儿 (

= 51, GI group and

= 51，GI 组和

= 45, ELBW group). The rates of abnormal general movements between the groups were comparable (writhing movements: 61% vs. 59%,

= 45，ELBW组）。各组之间异常全身运动的发生率具有可比性（扭动运动：61% vs. 59%，

= 0.89; fidgety movements: 20% vs. 36%,

= 0.89；不安运动：20% vs. 36%，

= 0.13). Writhing movements were different (100% poor repertoire, 0% cramped synchronous in the GI group vs. 50% poor repertoire and 50% cramped synchronous in the ELBW group,

= 0.13)。扭动运动有所不同（GI组中100%表现为贫乏的动作库，0%表现为痉挛同步，而ELBW组中50%表现为贫乏的动作库，50%表现为痉挛同步，

< 0.001).

< 0.001)。

Conclusion

结论

Infants with gastrointestinal anomalies are at risk for abnormal general movements. Abnormal fidgety general movements may be an early biomarker for future motor deficits.

患有胃肠道异常的婴儿存在一般运动异常的风险。异常的烦躁般的一般运动可能是未来运动缺陷的早期生物标志物。

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Early detection of general movements trajectories in very low birth weight infants

极低出生体重婴儿一般运动轨迹的早期检测

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开放获取

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2020年8月6日

Preterm and writhing movements: is it possible to predict fidgety movements in preterm infants?

早产和扭动运动：是否可以预测早产儿的不安运动？

Article

文章

13 May 2021

2021年5月13日

General Movements trajectories and outcome at 12 months in very preterm infants: An analysis of tendencies and pathological persistence

极早产儿的一般运动轨迹和12个月时的结果：对趋势和病理性持续性的分析

Article

文章

Open access

开放获取

09 December 2023

2023年12月9日

Introduction

简介

Neonates born with congenital gastrointestinal anomalies are at risk for neurodevelopmental impairment. They are often born premature, require prolonged hospital stays, multiple surgeries, anesthesia, and mechanical ventilation, and are at high risk for poor growth, malnutrition, and infections—all of which adversely impact neurodevelopment [.

出生时患有先天性胃肠道异常的新生儿有神经发育障碍的风险。他们往往早产，需要长时间住院、多次手术、麻醉和机械通气，并且面临生长不良、营养不良和感染的高风险——所有这些都会对神经发育产生不利影响。

，

In comparison to premature infants, there is a paucity of literature exploring the neurodevelopment of infants born with gastrointestinal anomalies [

与早产儿相比，关于出生时患有胃肠道异常的婴儿神经发育的文献较少 [

，

]. Studies have demonstrated that extremely low birth weight infants (ELBW, birth weight < 1 kg) are at high risk for motor, cognitive, and behavioral impairments [

]. 研究表明，极低出生体重儿（ELBW，出生体重 < 1 公斤）存在运动、认知和行为障碍的高风险 [

，

]. Most ELBW infants are followed after hospital discharge from the neonatal intensive care unit (NICU) with serial neurodevelopmental assessments [

].大多数ELBW婴儿在新生儿重症监护室（NICU）出院后会接受系列神经发育评估 [

]. However, follow-up for infants with gastrointestinal anomalies is not standard practice. Research has demonstrated that early identification and intervention decreases the risk of developmental disability [

]. 但是，对胃肠道畸形婴儿的随访并不是标准做法。研究表明，早期识别和干预可降低发育障碍的风险 [

，

Identifying infants at risk of neurodevelopmental impairment requires practical, reliable, and cost-effective assessments. Prechtl’s General Movements is a low-cost, high-yield tool used to predict motor delays. It is utilized to predict cerebral palsy as early as three to four months post-term [

识别有神经发育障碍风险的婴儿需要实用、可靠且经济高效的评估方法。普雷希特尔的全身运动是一种低成本、高收益的工具，用于预测运动迟缓。它被用来在出生后三到四个月预测脑瘫 [

，

]. General movements are motor patterns endogenously produced by the young, adapting nervous system. The infant is observed in a supine position while awake at two stages of development [

].总体运动是由幼小、适应性神经系统内源性产生的运动模式。婴儿在清醒时被观察到处于仰卧位的两个发育阶段[

]. When the nervous system is impaired, general movement quality changes. Writhing movements are observed at both preterm and term age and are categorized as either normal writhing, poor repertoire, or cramped synchronous. Fidgety movements are observed around three to four months post-term age. They are categorized as normal, abnormal, or absent..

]. 当神经系统受损时，整体运动质量会发生变化。在早产和足月龄时都能观察到扭动运动，并将其分为正常扭动、动作单调或僵硬同步。烦躁运动在足月后大约三到四个月时被观察到，分为正常、异常或缺失。

General movement assessments are highly sensitive and specific in predicting cerebral palsy with studies reporting a sensitivity as high as 98–100% [

通用运动评估在预测脑瘫方面具有高度的敏感性和特异性，研究报告的敏感性高达98-100% [

，

]. General movement assessments, particularly at the fidgety age, have been found to have a higher sensitivity and specificity than common imaging modalities including magnetic resonance imaging and head ultrasounds [

]. 一般运动评估，尤其是在多动期，已被发现比包括磁共振成像和头部超声波在内的常见影像学方法具有更高的敏感性和特异性 [

，

]. In comparison to magnetic resonance imaging and head ultrasound, general movements are easier to collect and more cost-effective. Caregivers can videotape the infant at home and send these videos to certified practitioners for review.

与磁共振成像和头部超声相比，全身运动更容易收集且更具成本效益。照顾者可以在家中拍摄婴儿的视频，并将这些视频发送给认证的专业人员进行审查。

Since there is a lack of literature on the neurodevelopmental outcomes in infants born with congenital gastrointestinal anomalies, our study aimed to characterize general movements in this population and compare them to another high-risk population that is cared for in the NICU, ELBW infants. With a better understanding, our ultimate goal is to determine if general movement assessments have a role in predicting long-term neurodevelopmental outcomes in this population..

由于目前关于先天性胃肠道畸形婴儿的神经发育结果的文献较少，我们的研究旨在描述这一人群的总体运动特征，并将其与在新生儿重症监护室（NICU）中护理的另一高危群体——极低出生体重儿（ELBW）进行比较。通过更好地理解，我们的最终目标是确定总体运动评估是否在预测这一人群的长期神经发育结果方面具有作用。

Materials and methods

材料与方法

This is a retrospective, single-site study that included infants born at the University of California Los Angeles between March 2018 and December 2022 and admitted to the NICU. Inclusion criteria included those born with a congenital gastrointestinal anomaly or birth weight < 1 kg (ELBW). Congenital gastrointestinal anomalies included anatomical anomalies that were present at birth including tracheoesophageal fistula, abdominal wall defects, congenital diaphragmatic hernia, intestinal atresia, Hirschsprung’s disease, and anorectal malformations.

这是一项回顾性、单中心研究，纳入了2018年3月至2022年12月期间在加州大学洛杉矶分校出生并入住新生儿重症监护室（NICU）的婴儿。纳入标准包括出生时患有先天性胃肠道畸形或出生体重<1公斤（极低出生体重，ELBW）的婴儿。先天性胃肠道畸形包括出生时存在的解剖学异常，包括气管食管瘘、腹壁缺陷、先天性膈疝、肠闭锁、赫希朋病和肛门直肠畸形。

Patients that were included underwent at least one general movement assessment. Patients who expired before hospital discharge or those with a known chromosomal anomaly were excluded from the study. Included patients were divided into two groups, those with a congenital gastrointestinal anomaly (GI group) and those who were ELBW (ELBW group).

纳入研究的患者至少接受过一次全身运动评估。在出院前死亡或已知有染色体异常的患者被排除在研究之外。纳入研究的患者分为两组，一组是患有先天性胃肠道畸形的患者（GI组），另一组是极低出生体重儿（ELBW组）。

This study was approved by our local Institutional Review Board..

本研究经我院当地机构审查委员会批准。

Demographic data was collected from infant and maternal electronic medical records. Data collected from the subject’s hospital courses included variables that are known to impact neurodevelopment such as fetal growth restriction, early and late onset sepsis, duration of parental nutrition, mechanical ventilation, and intraventricular hemorrhage..

人口统计数据是从婴儿和母亲的电子医疗记录中收集的。从受试者的住院过程中收集的数据包括已知会影响神经发育的变量，如胎儿生长受限、早发和晚发败血症、肠外营养持续时间、机械通气以及脑室内出血。

Starting in 2018, general movement assessments were obtained for infants admitted to the NICU that did not qualify for long-term neurodevelopmental follow-up. In 2020, the program was adjusted to screen all infants that required seven or more days in the NICU. General movement assessments were administered at two ages.

从2018年开始，对入住新生儿重症监护室（NICU）但不符合长期神经发育随访条件的婴儿进行了整体运动评估。2020年，该计划调整为筛查所有需要在NICU住院七天或以上的婴儿。整体运动评估在两个年龄段进行。

Writhing general movements were observed at 36–46 weeks corrected gestational age while patients were in the NICU. Fidgety general movements were observed at 3–4 months post-term age as part of a multidisciplinary clinic appointment or in the inpatient setting if the infant was hospitalized. For both assessments, infants were recorded by video.

在矫正胎龄36-46周期间，患儿在新生儿重症监护室（NICU）中被观察到有扭曲的全身运动。在出生后3-4个月的多学科门诊预约期间，或如果婴儿住院则在住院环境下，观察到烦躁的全身运动。对于这两项评估，婴儿均通过视频进行了记录。

Videos were reviewed by health care professionals certified in general movement assessments. Writhing movements were categorized as normal or abnormal. Abnormal writhing general movements were further categorized as poor repertoire or cramped synchronous. Fidgety general movements were characterized as normal fidgety, absent fidgety, or abnormal fidgety..

视频由经过全身运动评估认证的医疗专业人员进行审查。扭动运动被分为正常或异常。异常的扭动全身运动进一步分为贫乏型或痉挛同步型。不安运动被描述为正常不安、缺失不安或异常不安。

Statistics

统计学

Patient characteristics and study variables were summarized by group (GI group and ELBW group) using mean (SD) or frequency (%) as appropriate. These variables were compared using the t-test or chi-square test, as appropriate. To assess the association between abnormal general movement assessment (abnormal writhing/abnormal fidgety) and gestational age and birth weight, univariable logistic regression models were utilized.

患者特征和研究变量按组（GI组和ELBW组）使用均值（标准差）或频率（百分比）进行总结。这些变量使用t检验或卡方检验进行比较，视情况而定。为了评估异常全身运动评估（异常扭动/异常不安运动）与胎龄和出生体重之间的关联，采用了单变量逻辑回归模型。

Statistical analyses were conducted using R V4.1.0 (.

统计分析使用 R V4.1.0 进行。

www.r-project.org

; Vienna, AU), and

；维也纳，奥地利），以及

-values < 0.05 were considered statistically significant.

-values < 0.05 被认为具有统计学显著性。

Results

结果

Ninety-six infants met inclusion criteria. There were 51 subjects in the GI group and 45 subjects in the ELBW group. The GI group included a heterogenous group of congenital anomalies: tracheoesophageal fistula (22%,

符合纳入标准的婴儿有96名。GI组有51名受试者，ELBW组有45名受试者。GI组包括各种先天性异常的异质群体：气管食管瘘（22%，

= 11), gastroschisis (22%,

= 11)，腹裂（22%，

= 11), congenital diaphragmatic hernia (16%,

= 11)，先天性膈疝（16%，

= 8), anorectal malformations (12%,

= 8)，肛门直肠畸形（12%，

= 6), Hirschsprung’s disease (6%,

= 6)，赫什朋病（6%，

= 3), and other abnormalities (22%,

= 3），以及其他异常（22%，

= 12).

= 12)。

When the ELBW group was compared to the GI group, the mean (SD) gestational age and birth weight were significantly different (26 (2) weeks vs. 35 (4.7) weeks,

当将极低出生体重（ELBW）组与胃肠（GI）组进行比较时，平均（标准差）胎龄和出生体重存在显著差异（26（2）周 vs. 35（4.7）周，

< 0.001 and 715 (160.5) g vs. 2408 (1001.2) g,

< 0.001 和 715 (160.5) 克 vs. 2408 (1001.2) 克，

< 0.001). The ELBW group also had higher rates of co-morbidities associated with prematurity, including necrotizing enterocolitis (13% vs. 2%,

<0.001）。ELBW组还具有更高的与早产相关的共病率，包括坏死性小肠结肠炎（13% 对 2%，

= 0.048), late onset sepsis (24% vs. 4%,

= 0.048)，晚发性败血症（24% 对 4%，

= 0.003), and all grades of intraventricular hemorrhages (47% vs. 10%,

= 0.003)，以及所有级别的脑室内出血（47% 对 10%，

< 0.001). The GI group underwent more surgeries (2 (1) vs 1 (1),

<0.001）。GI组进行了更多的手术（2（1）vs 1（1），

< 0.001), including abdominal surgeries (1 (0.7) vs 0.4 (0.7),

<0.001），包括腹部手术（1（0.7） vs 0.4（0.7），

< 0.001) (Table

<0.001)（表

）。

Table 1 Maternal and neonatal characteristics of extremely low birthweight infants and those born with congenital gastrointestinal anomalies.

表1 极低出生体重儿及其先天性胃肠道畸形新生儿的母体和新生儿特征。

Full size table

全尺寸表格

In the GI group, 66% (

在GI组中，66% (

= 34) of infants had a writhing general movement assessment, 64% (

= 34) 的婴儿有扭动全身运动评估，64% (

= 33) had a fidgety general movement assessment, and 23% (

= 33) 有烦躁不安的全身运动评估，23% (

= 12) underwent both assessments. In the ELBW group, 82% (

= 12) 接受了两次评估。在极低出生体重（ELBW）组中，82% (

= 37) had a writhing general movement assessment, 77% (

= 37) 有扭动全身运动评估，77% (

= 35) had a fidgety general movement assessment, and 62% (

= 35）有烦躁的全身运动评估，62%（

= 28) underwent both assessments. Neonates in the GI group demonstrated abnormal general movements. There was no significant difference in the rate of abnormal general movements between the two groups. For the writhing movements, 58% and 59% of assessments were abnormal for the GI group and ELBW group, respectively (.

= 28）的新生儿接受了两项评估。胃肠道组的新生儿表现出异常的全身运动。两组之间异常全身运动的发生率没有显著差异。对于扭动运动，胃肠道组和极低出生体重组分别有58%和59%的评估结果为异常（。

= 0.96). For the fidgety movements, 15% of the assessments were abnormal for the GI group vs. 34% for the ELBW group were abnormal (

= 0.96）。对于不安运动，GI 组中有 15% 的评估结果异常，而 ELBW 组中有 34% 的评估结果异常（

= 0.07).

= 0.07)。

Writhing general movements were significantly different between the two groups (

两组之间的全身扭动显著不同 (

< 0.001). Forty-one percent (

<0.001）。百分之四十一（

= 14) of the GI group had a normal writhing general movement and 59% (

= 14) 的 GI 组有正常的扭动总体运动，59% (

= 20) of the general movements were characterized as poor repertoire. The ELBW group demonstrated a different pattern; 40% (

= 20) 的一般运动被描述为贫乏型。极低出生体重儿组表现出不同的模式；40% (

= 15) had a normal writhing general movement; 30% (

= 15) 有正常的扭动全身运动；30% (

= 11) of the general movement were characterized as poor repertoire; and 30% (

= 11) 的一般运动被描述为贫乏的组合；而 30% (

= 11) were characterized as cramped synchronous. Fidgety general movements were not significantly different between the two groups (

= 11）被描述为局促同步。不安的全身运动在两组之间没有显著差异（

= 0.076) (Fig.

= 0.076)（图。

）。

Fig. 1: General movement assessments.

图1：总体运动评估。

GMA general movement assessments, GI gastrointestinal, ELBW extremely low birthweight.

GMA全身运动评估，GI胃肠道，ELBW极低出生体重。

Full size image

全尺寸图像

Within each group, we compared the characteristics of neonates with abnormal versus normal general movements for each developmental stage. For writhing movements, infants with congenital gastrointestinal anomalies who had abnormal general movements were intubated longer than those with normal general movements (30 (27) days vs.

在每个组内，我们比较了每个发育阶段一般运动异常与正常的新生儿特征。对于扭动运动，患有先天性胃肠道畸形且一般运动异常的婴儿比一般运动正常的婴儿插管时间更长（30（27）天 vs.

10 (11) days, .

10（11）天，。

= 0.045). In the ELBW group, infants with abnormal general movements were born at a younger gestational age (25 (2) weeks vs. 27 (2) weeks,

= 0.045）。在极低出生体重儿组中，全身运动异常的婴儿胎龄更小（25（2）周 vs. 27（2）周，

= 0.021), were intubated longer (45 (18) days vs. 22 (18) days,

= 0.021)，插管时间更长（45（18）天 vs. 22（18）天，

< 0.001), and had higher rates of all grades of intraventricular hemorrhage (64% vs. 27%,

<0.001），且所有等级的脑室内出血率较高（64% vs. 27%，

= 0.027). In both groups, there was no significant difference in the number of surgeries between infants with abnormal and normal general movements (ELBW group: 0.63 (0.95) vs. 0.53 (0.74),

= 0.027）。在两组中，异常和正常全身运动的婴儿在手术次数上没有显著差异（ELBW组：0.63（0.95） vs. 0.53（0.74），

= 0.72, GI group 1.8 (0.95) vs 1.4 (0.84),

= 0.72，GI组 1.8 (0.95) 对比 1.4 (0.84)，

= 0.18).

= 0.18)。

For fidgety movements within the GI group, those with abnormal or absent fidgety movements were born at a younger gestational age (30 (5.3) weeks vs. 36 (4.7) weeks,

对于胃肠组内烦躁不安的动作，那些具有异常或缺乏烦躁动作的婴儿出生时的胎龄较小（30（5.3）周 vs. 36（4.7）周，

= 0.026), lower birth weight (1263 (811) g vs. 2538 (989) g,

= 0.026)，较低的出生体重（1263 (811) 克 vs. 2538 (989) 克，

= 0.011), and had higher rates of fetal growth restriction (80% vs. 23%

= 0.011），胎儿生长受限的发生率更高（80% 对比 23%

= 0.03) compared to those with normal fidgety movements. In the ELBW group, those with abnormal or absent fidgety movements had lower birth weights (646 (183) g vs. 766 (137) g,

= 0.03）相比那些正常活动的婴儿。在极低出生体重（ELBW）组中，那些活动异常或缺失的婴儿出生体重较低（646（183）克 vs. 766（137）克，

= 0.035), were intubated longer (45 (23) days vs. 27(23) days,

= 0.035)，插管时间更长（45（23）天 vs. 27（23）天，

= 0.039), and had higher rates of all grades of intraventricular hemorrhage (67% vs 30%,

= 0.039），且所有级别的脑室内出血发生率更高（67% vs 30%，

= 0.040) compared to those with normal fidgety movements. Again, in both groups, there was no significant difference in the number of surgeries between infants with abnormal and normal general movements (ELBW group 0.92 (1.2) vs 0.65 (0.83),

= 0.040)，与正常抖动运动的婴儿相比。同样，在两组中，异常和正常全身运动的婴儿在手术次数上没有显著差异（ELBW组 0.92 (1.2) 对 0.65 (0.83)，

= 0.45, GI group 2 (1.2) vs 1.8 (1),

= 0.45，GI组2（1.2）对比1.8（1），

= 0.39).

= 0.39)。

Logistic regression analyses revealed increased odds of abnormal general movements with lower birth weights and younger gestational ages. In the GI group, the odds of abnormal or absent fidgety movements increased by 17% (OR 0.83, 95% CI 0.70–0.99,

逻辑回归分析显示，出生体重较低和胎龄较小的婴儿，其一般运动异常的几率增加。在GI组中，异常或缺失的烦躁运动的几率增加了17%（OR 0.83，95% CI 0.70-0.99，

= 0.036) for each week decrease in gestational age. The odds of abnormal or absent fidgety movements also increased by 50% (OR 0.50, 95% CI 0.28–0.88,

= 0.036），胎龄每减少一周，异常或不安运动缺失的几率也增加了50%（OR 0.50，95% CI 0.28–0.88，

= 0.017) for each 500 g decrease in birth weight. In the ELBW group, the odds of abnormal writhing movements increased by 37% (OR 0.63, 95% CI 0.41–0.97,

= 0.017)，每减少500克出生体重。在极低出生体重组中，异常扭动运动的几率增加了37%（OR 0.63，95% CI 0.41–0.97，

= 0.036) for each week decrease in gestational age. The odds of abnormal or absent fidgety movements increased by 93% (OR 0.07, 95% CI 0.01–0.88,

= 0.036)，孕周每减少一周，异常或缺失的扭动运动的几率增加93%（OR 0.07，95% CI 0.01–0.88，

= 0.40) for every 500 g decrease in birth weight (Table

= 0.40)，每减少500克出生体重（表

）。

Table 2 Association between birth weight and gestational age with abnormal writhing movements (abnormal writhing) and abnormal fidgety movements (abnormal or absent fidgety).

表2 出生体重和胎龄与异常蠕动运动（异常蠕动）和异常扭动运动（异常或缺失扭动）之间的关联。

Full size table

全尺寸表格

Discussion

讨论

In this study, infants born with gastrointestinal anomalies had the same rate of abnormal general movements as ELBW infants. The two groups demonstrated a significantly different pattern for writhing movements. As anticipated, in both groups, abnormal general movements were associated with prematurity and low birth weights.

在这项研究中，出生时患有胃肠道异常的婴儿与极低出生体重儿的异常全身运动发生率相同。两组在扭动运动模式上表现出显著差异。正如预期的那样，在这两组中，异常全身运动均与早产和低出生体重有关。

Given these findings, further research is needed to determine if general movements in the neonatal gastrointestinal population correlate with long-term neurodevelopmental outcomes..

鉴于这些发现，需要进一步研究来确定新生儿胃肠病人群体的一般运动是否与长期神经发育结果相关。

Studies have examined the neurodevelopmental outcomes of those born with congenital gastrointestinal anomalies and have found that these infants are at risk for long-term neurological dysfunction [

研究已经检查了那些出生时患有先天性胃肠道异常的神经发育结果，并发现这些婴儿存在长期神经功能障碍的风险。

，

]. Roorda et al. performed a systemic review and meta-analysis of studies examining cognitive, motor, and language outcomes of those born with congenital gastrointestinal anomalies. Overall, these infants were found to have significant cognitive, motor, and language impairments [

]. Roorda 等人对研究先天性胃肠道异常婴儿的认知、运动和语言结果的相关研究进行了系统回顾和荟萃分析。总体而言，这些婴儿被发现存在显著的认知、运动和语言障碍 [

]. In a prospective cohort study of infants born with congenital anomalies who underwent cardiac and noncardiac surgery at 1 and 3 years of age, the study population scored lower than the general population on the Bayley Scales Infant and Toddler Development-III assessment [

]. 在一项针对出生时患有先天性异常并在1岁和3岁时接受心脏和非心脏手术的婴儿的前瞻性队列研究中，研究人群在贝利婴儿和幼儿发展量表-III评估中得分低于一般人群 [

，

]. Studies have also examined specific congenital anomalies. In one study, infants with tracheoesophageal fistulas had lower intelligence quotients and were more likely to have emotional and behavioral problems compared to controls [

]. 还有研究探讨了特定的先天性异常。在一项研究中，患有气管食管瘘的婴儿智力商数较低，并且比对照组更容易出现情绪和行为问题 [

]. Friedman et al. found that those with congenital diaphragmatic hernias had higher rates of motor and language delays up to 3 years old [

]. 弗里德曼等人发现，患有先天性膈疝的儿童在三岁前运动和语言发育迟缓的比例较高 [

]. Considering the literature, long-term neurodevelopmental follow-up for infants born with congenital gastrointestinal anomalies appears to be warranted.

]. 根据文献，对出生时患有先天性胃肠道畸形的婴儿进行长期神经发育随访似乎是必要的。

Historically, general movements have been most reliable in predicting motor outcomes in very preterm infants [

历史上，总体运动最可靠地预测了极早产儿的运动结果 [

]. Cramped synchronous movements at the writhing stage followed by absent fidgety movements are the most sensitive for predicting cerebral palsy [

]. 在蠕动阶段，受限的同步运动随后出现无烦躁运动，这是预测脑瘫最敏感的指标 [

，

]. Studies investigating the utility of general movements for predicting mild neurological deficits have had variable results. This is likely because of heterogenous study populations, different neurodevelopmental assessments, and the availability of general movement assessments. Darsaklis et al. undertook a systemic review exploring the predictive value of general movements for neurodevelopmental outcomes at multiple ages.

]. 研究通用运动对预测轻度神经功能缺损的效用的结果各有不同。这可能是因为研究人群异质性、不同的神经发育评估以及通用运动评估的可用性。Darsaklis 等人进行了一项系统评价，探讨了通用运动在多个年龄段对神经发育结果的预测价值。

They found that the sensitivities and specificities for mild neurological deficits were lower than the sensitivities and specificities for cerebral palsy [.

他们发现，对于轻度神经功能缺损的敏感性和特异性低于脑瘫的敏感性和特异性。

]. For writhing movements at 12–23 months, the sensitivities ranged from 75 to 100% for predicting cerebral palsy. Likewise, the sensitivity for writhing movements was 75–86% in predicting scores on standardized developmental assessments. Fidgety movements had a high sensitivity for cerebral palsy (100%), but lower sensitivity (38–62.5%) in predicting scores on standardized developmental assessments [.

。对于12-23个月的扭动运动，预测脑瘫的敏感性范围为75%至100%。同样，扭动运动在预测标准化发育评估分数方面的敏感性为75%-86%。不安运动对脑瘫的敏感性很高（100%），但在预测标准化发育评估分数方面的敏感性较低（38%-62.5%）[

Further studies will be needed to determine the significance of abnormal general movements within the gastrointestinal population. In our study, the gastrointestinal group had significantly higher rates of poor repertoire writhing movements compared to ELBW infants. The long-term significance of this finding remains unclear.

需要进一步的研究来确定胃肠道人群中异常全身运动的意义。在我们的研究中，胃肠道组的不良扭动运动发生率显著高于极低出生体重儿。这一发现的长期意义尚不清楚。

Many infants with poor repertoire writhing movements will have normal fidgety movements and normal development [.

许多表现差的婴儿扭动运动将有正常的烦躁运动和正常的发展 [。

]. In comparison, infants with cramped synchronous writhing movements have higher rates of abnormal or absent fidgety movements and developmental impairments [

]. 相比之下，具有受限同步扭动运动的婴儿，其异常或缺失的烦躁运动和发育障碍的发生率较高 [

，

]. In a study examining general movements in the neonatal surgical population, 84% of infants with abnormal writhing movements went on to have normal fidgety movements. While those with normal fidgety movements did not demonstrate cerebral palsy at 1 year of age, 48% had developmental delays [

]. 在一项针对新生儿外科人群的全身运动研究中，84% 的有异常扭动运动的婴儿后来出现了正常的烦躁运动。虽然那些有正常烦躁运动的婴儿在 1 岁时没有表现出脑瘫，但 48% 的婴儿存在发育迟缓 [

]. These transitory changes in writhing general movements may reflect short-term exogenous factors such as infections, postnatal steroid therapy, analgesic medications, and the presence of a patent ductus arteriosus rather than a brain injury that alters long-term development [

这些短暂的扭动和整体运动的变化可能反映了短期的外源性因素，如感染、产后类固醇治疗、镇痛药物以及动脉导管未闭，而不是改变长期发展的脑损伤。

，

In our study, infants with abnormal general movements were born at younger gestational ages, lower birth weights and were intubated for longer periods of time. ELBW infants with abnormal general movements also had higher rates of all grades of intraventricular hemorrhage. These findings are consistent with the literature [.

在我们的研究中，全身运动异常的婴儿出生时胎龄较小，出生体重较低，并且插管时间较长。全身运动异常的极低出生体重儿（ELBW）的所有等级的脑室内出血率也较高。这些发现与文献一致。

，

]. Maeda et al. explored the association of general movement quality and brain morphological development using magnetic resonance imaging. Mechanical ventilation was correlated with abnormal general movements [

]. 前田等人利用磁共振成像技术探索了整体运动质量与大脑形态发育之间的关联。机械通气与异常的整体运动相关 [

]. In another study, investigators noted the absence of intraventricular hemorrhage grades I-II reduced the chances of an abnormal general movement by 77%. Each day of invasive mechanical ventilation increased the odds of an abnormal general movement by 1.11 (95% CI 1.01–1.22,

]. 在另一项研究中，调查人员注意到，没有出现脑室内出血I-II级的情况可使异常全身运动的几率减少77%。每天进行有创机械通气都会使异常全身运动的几率增加1.11（95%置信区间1.01-1.22）。

= 0.025) [

]. While intraventricular hemorrhage causes direct injury to the brain, mechanical ventilation affects brain oxygenation and metabolism.

]. 虽然脑室内出血对大脑造成直接损伤，但机械通气会影响大脑的氧合和代谢。

Twenty-five percent of infants born with gastrointestinal anomalies in our study were fetal growth restricted. These infants had significantly higher rates of abnormal or absent fidgety general movements. Fetal growth restriction has been shown to directly affect brain development through multiple mechanisms [.

在我们的研究中，25%的出生时患有胃肠道异常的婴儿存在胎儿生长受限。这些婴儿的异常或缺失不安运动的发生率显著较高。胎儿生长受限已被证明通过多种机制直接影响大脑发育。

]. Fetal growth restriction is a reflection of placental insufficiency resulting in chronic fetal hypoxia. Fetal growth restriction is associated with reduced total brain volume, altered brain structures, and a decreased total number of cells [

]. 胎儿生长受限是胎盘功能不全导致慢性胎儿缺氧的反映。胎儿生长受限与脑总体积减少、脑结构改变及细胞总数减少有关 [

Multiple factors likely contribute to the development of abnormal movements in those born with congenital gastrointestinal anomalies. These infants are exposed to various perinatal risk factors including environmental hazards (i.e., maternal smoking) and are at increased risk for non-gastrointestinal congenital anomalies [.

多种因素可能导致先天性胃肠道畸形患儿出现异常运动。这些婴儿暴露于各种围产期风险因素，包括环境危害（如母亲吸烟），并且非胃肠道先天性畸形的风险增加。

，

]. Central nervous system malformations directly affect brain architecture and can alter function. None of the subjects included in our study had known central nervous system abnormalities. This finding is limited. Most infants underwent cranial ultrasounds; however only one-third underwent a brain MRI.

中枢神经系统畸形直接影响大脑结构并可能改变功能。我们研究中包含的受试者均无已知的中枢神经系统异常。这一发现具有局限性。大多数婴儿接受了颅脑超声检查；但只有三分之一的婴儿接受了脑部MRI检查。

It would be interesting for future studies to better characterize the frequency of cranial abnormalities in this population..

未来的研究如果能更好地描述这一人群颅骨异常的频率，将会很有趣。

High rates of surgical intervention in those born with congenital gastrointestinal anomalies also likely contributes to abnormal general movements. The GI group in our study underwent significantly more surgeries than the ELBW group. Infants with abnormal general movements did not have higher rates of surgery when compared to those with normal general movements.

先天性胃肠道畸形患儿的高手术干预率也可能导致异常的整体运动。我们研究中的胃肠道组比极低出生体重组经历了明显更多的手术。然而，与整体运动正常的婴儿相比，整体运动异常的婴儿手术率并未更高。

Surgery carries multiple risks including anesthesia, intubation, prolonged immobilization, infections, and surgical complications. Prior studies have found a correlation between surgeries and developmental outcomes. In a systemic review and metanalysis of neurodevelopmental outcomes of patients with congenital gastrointestinal malformations, there was a higher rate of neurodevelopment impairment compared with normative data or healthy controls (d = −0.49, 95% CI −0.61 to −0.38, .

手术有多种风险，包括麻醉、插管、长时间固定不动、感染和手术并发症。先前的研究发现手术与发育结果之间存在相关性。在对先天性胃肠道畸形患者的神经发育结果进行的系统评价和荟萃分析中，与正常数据或健康对照组相比，神经发育受损的比例较高（d = -0.49，95% CI -0.61 至 -0.38）。

< 0.001). Poor outcomes were related to the number of surgeries and length of hospital stay (b = −0.005,

<0.001）。不良结果与手术次数和住院时间有关（b = -0.005，

< 0.001 and b = −0.1371,

< 0.001 且 b = −0.1371，

= 0.003) [

]. Immobilization following surgery delays exposure to core abdominal strengthening exercises and environmental exploration that promotes development.

手术后的固定会延迟暴露于核心腹部强化锻炼和促进发展的环境探索。

Furthermore, animal studies have demonstrated that anesthetic agents have a direct neurotoxic effect on neurons. Rats exposed to drugs that block NMDA glutaminergic receptors or drugs that potentiate GABA receptors have widespread apoptotic neurodegeneration [

此外，动物研究表明，麻醉剂对神经元有直接的神经毒性作用。暴露于阻断NMDA谷氨酸受体或增强GABA受体的药物中的大鼠会出现广泛的凋亡性神经退行性变[

]. In children, cumulative doses of anesthetics increases the risk of learning disorders (hazard ratio for 2 anesthetics = 1.59, 95% CI 1.06–2.37, and hazard ratio for ≥3 anesthetics = 2.60, 95% CI 1.60–4.24) [

]. 在儿童中，麻醉药物的累积剂量会增加学习障碍的风险（使用2次麻醉药物的风险比=1.59，95%置信区间1.06–2.37，使用≥3次麻醉药物的风险比=2.60，95%置信区间1.60–4.24）[

We acknowledge that this study has multiple limitations. This is a single-site, retrospective study with a small sample size. Gastrointestinal congenital anomalies are also heterogenous. With a larger sample size, specific sub-analyses would have been possible. We recognize that there are multiple differences between our population of interest, infants with gastrointestinal disorders, and our comparison group, ELBW infants.

我们承认这项研究存在多个局限性。这是一项单中心、回顾性研究，样本量较小。胃肠道先天性异常也具有异质性。如果样本量更大，特定的子分析可能会实现。我们认识到，我们感兴趣的人群（患有胃肠道疾病的婴儿）与对照组（极低出生体重儿）之间存在多方面的差异。

Our goal was to compare infants with gastrointestinal anomalies to a population with a known risk for abnormal general movements and neurodevelopmental impairment. Not all subjects had imaging data. We were unable to accurately quantify the type and duration of anesthetic exposures due to the retrospective nature of this study.

我们的目标是将患有胃肠道异常的婴儿与已知有异常全身运动和神经发育障碍风险的人群进行比较。并非所有受试者都有影像学数据。由于本研究的回顾性性质，我们无法准确量化麻醉暴露的类型和持续时间。

Lastly, we lack long-term neurodevelopmental data and general movement assessments are not performed consistently on all subjects. Missing data may have altered our results..

最后，我们缺乏长期的神经发育数据，并且没有对所有受试者一致地进行一般运动评估。缺失的数据可能改变了我们的结果。

In conclusion, in our study, 58% of the infants with congenital gastrointestinal anomalies had abnormal writhing movements and 15% had abnormal fidgety movements. We speculate that infants born with congenital gastrointestinal anomalies are at high risk for future neurodevelopmental impairments due to prematurity, low birth weight, and need for prolonged intubation and surgeries.

总之，在我们的研究中，58%的先天性胃肠道畸形婴儿有异常的扭动运动，15%有异常的烦躁运动。我们推测，由于早产、低出生体重以及需要长时间插管和手术，出生时患有先天性胃肠道畸形的婴儿未来出现神经发育障碍的风险较高。

Identifying those at the highest risk is vital to ensuring long-term follow-up. With improved long-term follow-up, practitioners have the opportunity to reduce poor neurodevelopmental outcomes through earlier interventions. Abnormal general movement may be an early biomarker for future deficits for infants born with congenital gastrointestinal anomalies..

识别出最高风险的个体对于确保长期随访至关重要。通过改进长期随访，临床医生有机会通过早期干预来减少不良神经发育结果。异常的全身运动可能是先天性胃肠道畸形婴儿未来缺陷的早期生物标志物。

Data availability

数据可用性

The datasets analyzed during the current study are available from the corresponding author on request.

当前研究中分析的数据集可根据要求从通讯作者处获取。

References

参考文献

Ludman L, Spitz L, Wade A. Educational attainments in early adolescence of infants who required major neonatal surgery. J Pediatr Surg. 2001;36:858–62.

Ludman L, Spitz L, Wade A. 需要重大新生儿手术的婴儿在青春期早期的教育成就。《儿科外科杂志》。2001年；36卷：858-62页。

Article

文章

CAS

中国科学院

PubMed

Google Scholar

谷歌学术

Zahed-Cheikh M, Brévaut-Malaty V, Busuttil M, Monnier AS, Roussel M, Gire C. Comparative analysis of perinatal and postnatal factors, and general movement in extremely preterm infants. Brain Dev. 2011;33:656–65.

Zahed-Cheikh M, Brévaut-Malaty V, Busuttil M, Monnier AS, Roussel M, Gire C。极早早产儿的围产期和产后因素及全身运动的比较分析。《大脑发育》2011；33：656–65。

Article

文章

PubMed

Google Scholar

谷歌学术

Wilder RT, Flick RP, Sprung J, Katusic SK, Barbaresi WJ, Mickelson C, et al. Early exposure to anesthesia and learning disabilities in a population-based birth cohort. Anesthesiology. 2009;110:796–804.

Wilder RT, Flick RP, Sprung J, Katusic SK, Barbaresi WJ, Mickelson C, 等。基于人群的出生队列中早期接触麻醉与学习障碍的关系。《麻醉学》。2009年；110:796–804。

Article

文章

PubMed

Google Scholar

谷歌学术

Walker K, Badawi N, Halliday R, Stewart J, Sholler GF, Winlaw DS, et al. Early developmental outcomes following major noncardiac and cardiac surgery in term infants: a population-based study. J Pediatr. 2012;161:748–52.

沃克 K、巴达维 N、哈利迪 R、斯图尔特 J、肖勒 GF、温劳 DS 等。足月婴儿重大非心脏和心脏手术后的早期发育结果：一项基于人群的研究。《儿科杂志》。2012年；161：748-52。

Article

文章

PubMed

Google Scholar

谷歌学术

Walker K, Loughran-Fowlds A, Halliday R, Holland AJ, Stewart J, Sholler GF, et al. Developmental outcomes at 3 years of age following major non-cardiac and cardiac surgery in term infants: A population-based study. J Paediatr Child Health. 2015;51:1221–5.

沃克 K，洛夫兰-福兹 A，哈利迪 R，霍兰德 AJ，斯图尔特 J，肖勒 GF，等。足月婴儿在进行重大非心脏和心脏手术后3岁的发育结果：一项基于人群的研究。《儿科与儿童健康杂志》。2015；51：1221–5。

Article

文章

PubMed

Google Scholar

谷歌学术

Hedrick HL, Crombleholme TM, Flake AW, Nance ML, von Allmen D, Howell LJ, et al. Right congenital diaphragmatic hernia: Prenatal assessment and outcome. J Pediatr Surg. 2004;39:319–23.

Hedrick HL, Crombleholme TM, Flake AW, Nance ML, von Allmen D, Howell LJ, 等。右先天性膈疝：产前评估与结果。《小儿外科杂志》。2004年；39:319-23。

Article

文章

PubMed

Google Scholar

谷歌学术索

Bouman NH, Koot HM, Hazebroek FW. Long-term physical, psychological, and social functioning of children with esophageal atresia. J Pediatr Surg. 1999;34:399–404.

布曼 NH，库特 HM，哈泽布鲁克 FW。食管闭锁儿童的长期身体、心理和社会功能。《小儿外科杂志》。1999年；34:399-404。

Article

文章

CAS

中国科学院

PubMed

Google Scholar

谷歌学术

Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJ. Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. JAMA. 2002;288:728–37.

Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJ. 早产出生的学龄儿童的认知和行为结果：一项荟萃分析。《美国医学会杂志》。2002年；288卷：728-37页。

Article

文章

PubMed

Google Scholar

谷歌学术索

Johnson S. Cognitive and behavioral outcomes following very preterm birth. Semin Fetal Neonatal Med. 2007;12:363–73.

约翰逊 S. 极早产出生后的认知和行为结果。《胎儿与新生儿医学杂志》。2007年；12：363-73。

Article

文章

PubMed

Google Scholar

谷歌学术搜索

Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet. 2008;371:261–9.

Saigal S，Doyle LW。从婴儿期到成年期早产死亡率和后遗症的概述。《柳叶刀》。2008;371:261–9。

Article

文章

PubMed

Google Scholar

谷歌学术搜索

de Kieviet JF, Piek JP, Aarnoudse-Moens CS, Oosterlaan J. Motor development in very preterm and very low-birth-weight children from birth to adolescence: a meta-analysis. JAMA. 2009;302:2235–42.

德克伊维特 JF，皮克 JP，阿诺德斯-穆恩斯 CS，奥斯特拉恩 J。从出生到青春期极早早产儿和极低出生体重儿童的运动发育：一项荟萃分析。《美国医学会杂志》。2009年；302:2235–42。

Article

文章

PubMed

Google Scholar

谷歌学术索

State of California, Department of Health Care Services. High Risk Infant Follow Up (HRIF) Program Services. DHCS: Sacramento; 2016. Available from:

加利福尼亚州卫生保健服务部。高危婴儿随访（HRIF）计划服务。DHCS：萨克拉门托；2016年。可从以下网址获取：

https://www.dhcs.ca.gov/services/ccs/Documents/ccsnl051016.pdf

2024.

2024年。

Hadders-Algra M. Evaluation of motor function in young infants by means of the assessment of general movements: a review. Pediatr Phys Ther. 2001;13:27–36.

Hadders-Algra M. 通过评估全身运动来评价幼婴的运动功能：一篇综述。《儿科物理治疗》。2001年；13卷：27-36页。

Article

文章

CAS

中国科学院

PubMed

Google Scholar

谷歌学术

Blauw-Hospers CH, Hadders-Algra M. A systematic review of the effects of early intervention on motor development. Dev Med Child Neurol. 2005;47:421–32.

布鲁-霍普斯 CH，哈达斯-阿尔格拉 M。早期干预对运动发育影响的系统综述。《发育医学与儿童神经学》。2005；47：421-32。

Article

文章

PubMed

Google Scholar

谷歌学术索

Majnemer A. Benefits of early intervention for children with developmental disabilities. Semin Pediatr Neurol. 1998;5:62–9.

Majnemer A. 发展障碍儿童早期干预的益处。《儿科神经病学研讨会》。1998;5:62–9。

Article

文章

CAS

中国科学院

PubMed

Google Scholar

谷歌学术搜索

Als H, Duffy FH, McAnulty GB, et al. Early experience alters brain function and structure. Pediatrics. 2004;113:846–57.

Als H, Duffy FH, McAnulty GB, 等。早期经验改变大脑功能和结构。《儿科学》。2004；113：846–57。

Article

文章

PubMed

Google Scholar

谷歌学术索

Einspieler C, Prechtl HF. Prechtl’s assessment of general movements: a diagnostic tool for the functional assessment of the young nervous system. Ment Retard Dev Disabil Res Rev. 2005;11:61–7.

Einspieler C, Prechtl HF. Prechtl的全身运动评估：一种用于年轻神经系统功能评估的诊断工具。《智力迟缓与发展障碍研究评论》，2005年；11卷：61-7页。

Article

文章

PubMed

Google Scholar

谷歌学术搜索

Bosanquet M, Copeland L, Ware R, Boyd R. A systematic review of tests to predict cerebral palsy in young children. Dev. Med. Child Neurol. 2013;55:418–26.

Bosanquet M，Copeland L，Ware R，Boyd R。预测幼儿脑瘫的测试的系统评价。《发育医学与儿童神经学》2013；55：418-26。

Article

文章

PubMed

Google Scholar

谷歌学术

Spittle AJ, Doyle LW, Boyd RN. A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life. Dev Med Child Neurol. 2008;50:254–66.

Spittle AJ，Doyle LW，Boyd RN。对早产儿在出生后第一年内神经运动评估的临床计量特性进行系统评价。《发育医学与儿童神经学》。2008年；50:254–66。

Article

文章

PubMed

Google Scholar

谷歌学术索

Ferrari F, Plessi C, Lucaccioni L, Bertoncelli N, Bedetti L, Ori L, et al. Motor and Postural Patterns Concomitant with General Movements Are Associated with Cerebral Palsy at Term and Fidgety Age in Preterm Infants. J Clin Med. 2019;8:1189.

法拉利 F、普莱西 C、卢卡奇尼 L、贝尔顿切利 N、贝代蒂 L、奥里 L 等。伴随全身运动的运动和姿势模式与早产儿在足月和扭动期的脑瘫相关。《临床医学杂志》。2019年；8：1189。

Article

文章

PubMed

PubMed Central

Google Scholar

谷歌学术索

Darsaklis V, Snider LM, Majnemer A, Mazer B. Predictive validity of Prechtl’s Method on the Qualitative Assessment of General Movements: a systematic review of the evidence. Dev Med Child Neurol. 2011;53:896–906.

达尔萨克利斯 V，斯奈德 LM，马尼梅尔 A，马泽 B. Prechtl 的一般运动质量评估方法的预测效度：证据的系统评价。《发育医学与儿童神经病学》。2011；53：896-906。

Article

文章

PubMed

Google Scholar

谷歌学术搜索

Prechtl HF, Einspieler C, Cioni G, Bos AF, Ferrari F, Sontheimer D. An early marker for neurological deficits after perinatal brain lesions. Lancet. 1997;349:1361–3.

Prechtl HF, Einspieler C, Cioni G, Bos AF, Ferrari F, Sontheimer D. 一种用于围产期脑损伤后神经功能缺损的早期标志物。《柳叶刀》。1997;349:1361–3。

Article

文章

CAS

中国科学院

PubMed

Google Scholar

谷歌学术

Roorda D, Königs M, Eeftinck Schattenkerk L, van der Steeg L, van Heurn E, Oosterlaan J. Neurodevelopmental outcome of patients with congenital gastrointestinal malformations: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2021;106:635–42.

Roorda D, Königs M, Eeftinck Schattenkerk L, van der Steeg L, van Heurn E, Oosterlaan J. 先天性胃肠道畸形患者的神经发育结果：系统评价与荟萃分析。《儿童疾病档案：胎儿与新生儿版》。2021年；106:635–42。

Article

文章

PubMed

Google Scholar

谷歌学术搜索

Friedman S, Chen C, Chapman JS, Jeruss S, Terrin N, Tighiouart H, et al. Neurodevelopmental outcomes of congenital diaphragmatic hernia survivors followed in a multidisciplinary clinic at ages 1 and 3. J Pediatr Surg. 2008;43:1035–43.

弗里德曼 S，陈 C，查普曼 JS，杰鲁斯 S，特林 N，蒂吉奥阿特 H，等。在多学科诊所随访的先天性膈疝存活者1岁和3岁时的神经发育结果。《小儿外科杂志》。2008年；43：1035-43。

Article

文章

PubMed

Google Scholar

谷歌学术搜索

Kwong AKL, Fitzgerald TL, Doyle LW, Cheong JLY, Spittle AJ. Predictive validity of spontaneous early infant movement for later cerebral palsy: a systematic review. Dev Med Child Neurol. 2018;60:480–9.

邝AKL，菲茨杰拉德TL，道尔LW，郑JLY，斯皮特尔AJ。早期婴儿自发运动对后期脑瘫的预测效度：一项系统综述。《发育医学与儿童神经学》。2018；60:480–9。

Article

文章

PubMed

Google Scholar

谷歌学术搜索

Crowle C, Walker K, Galea C, Novak I, Badawi N. General movement trajectories and neurodevelopment at 3months of age following neonatal surgery. Early Hum Dev. 2017;111:42–8.

Crowle C, Walker K, Galea C, Novak I, Badawi N。新生儿手术后3个月时的全身运动轨迹与神经发育。《早期人类发展》。2017；111：42-8。

Article

文章

PubMed

Google Scholar

谷歌学术

Crowle C, Galea C, Walker K, Novak I, Badawi N. Prediction of neurodevelopment at one year of age using the General Movements assessment in the neonatal surgical population. Early Hum Dev. 2018;118:42–7.

Crowle C, Galea C, Walker K, Novak I, Badawi N。使用新生儿外科人群中的全身运动评估预测一岁神经发育。《早期人类发展》。2018；118：42-7。

Article

文章

PubMed

Google Scholar

谷歌学术

Bos AF, Van Asperena RM, Leeuw DM, Prechtl HPR. The influence of septicaemia on spontaneous motility in preterm infants. Early Hum Dev. 1997;50:61–70.

Bos AF, Van Asperena RM, Leeuw DM, Prechtl HPR。败血症对早产儿自发运动的影响。《早期人类发展》。1997;50:61–70。

Article

文章

CAS

中国科学院

PubMed

Google Scholar

谷歌学术

Bos AF, Martijn A, van Asperen RM, Hadders-Algra M, Okken A, Prechtl HPR, et al. Qualitative assessment of general movements in high-risk preterm infants with chronic lung disease requiring dexamethasone therapy. J Pediatr. 1998;132:300–6.

Bos AF, Martijn A, van Asperen RM, Hadders-Algra M, Okken A, Prechtl HPR, 等。需要地塞米松治疗的慢性肺病高危早产儿的一般运动质量评估。《儿科杂志》。1998;132:300–6。

Article

文章

CAS

中国科学院

PubMed

Google Scholar

谷歌学术索

Wu YC, Bouwstra H, Heineman KR, Hadders-Algra M. Atypical general movements in the general population: Prevalence over the last 15 years and associated factors. Acta Paediatr. 2020;109:2762–9.

吴YC，布斯特拉H，海内曼KR，哈达斯-阿尔格拉M。一般人群中非典型全身运动：过去15年的患病率及相关因素。《儿科杂志》。2020年；109:2762–9。

Article

文章

PubMed

PubMed Central

Google Scholar

谷歌学术

de Mendonça KT, Lanza FC, de Sousa Morais RL, Camargos ACR. Clinical factors associated with abnormal general movements of preterm newborns during hospitalization in a neonatal intensive care unit. Early Hum Dev. 2022;174:105682.

门东萨KT，兰扎FC，德索萨·莫赖斯RL，卡马戈斯ACR。与住院新生儿重症监护病房的早产儿异常全身运动相关的临床因素。《早期人类发展》。2022；174：105682。

Article

文章

PubMed

Google Scholar

谷歌学术

Maeda T, Iwata H, Sekiguchi K, Takahashi M, Ihara K. The association between brain morphological development and the quality of general movements. Brain Dev. 2019;41:490–500.

前田T，岩田H，关口K，高桥M，井原K。大脑形态发育与一般运动质量之间的关联。《大脑发育》。2019年；41：490-500。

Article

文章

PubMed

Google Scholar

谷歌学术

Rieger-Fackeldey E, Schulz P, Schulze A. General Movements and Outcome in Children with Birthweights ≤500 Grams at Age 5 to 6 Years. Z Geburtshilfe Neonatol. 2020;224:86–92.

Rieger-Fackeldey E, Schulz P, Schulze A. 5至6岁时出生体重≤500克儿童的全身运动与预后。《产科学与新生儿学杂志》。2020年；224:86–92。

Article

文章

PubMed

Google Scholar

谷歌学术

Miller SL, Huppi PS, Mallard C. The consequences of fetal growth restriction on brain structure and neurodevelopmental outcome. J Physiol. 2016;594:807–23.

Miller SL, Huppi PS, Mallard C. 胎儿生长受限对脑结构和神经发育结果的影响。《生理学杂志》。2016年；594:807–23。

Article

文章

CAS

中国科学院

PubMed

PubMed Central

Google Scholar

谷歌学术

Lam PK, Torfs CP. Interaction between maternal smoking and malnutrition in infant risk of gastroschisis.

林PK，托夫斯CP。母亲吸烟与营养不良对婴儿腹裂风险的交互作用。

Birth defects research

出生缺陷研究

. Part A Clin Mol Teratol. 2006;76:182–6.

. Part A 临床分子畸胎学。2006;76:182–6.

Article

文章

CAS

中国科学院

Google Scholar

谷歌学术索

Salik I, Paul M. Tracheoesophageal Fistula. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.

Salik I, Paul M. 气管食管瘘。In: StatPearls。佛罗里达州金银岛：StatPearls 出版社；2024年。

Jevtovic-Todorovic V, Hartman RE, Izumi Y, Benshoff ND, Dikranian K, Zorumski C, et al. Early exposure to common anesthetic agents causes widespread neurodegeneration in the developing rat brain and persistent learning deficits. J Neurosci. 2003;23:876–82.

Jevtovic-Todorovic V, Hartman RE, Izumi Y, Benshoff ND, Dikranian K, Zorumski C, 等。早期暴露于常见麻醉剂会导致发育中的大鼠大脑广泛神经退化及持续的学习缺陷。《神经科学杂志》。2003;23:876–82。

Article

文章

CAS

中国科学院

PubMed

PubMed Central

Google Scholar

谷歌学术搜索

Reed A, Dimmitt R. Lawrence Moss; Clinical Management of Necrotizing Enterocolitis. Neoreviews. 2001;2:e110–7.

Reed A, Dimmitt R. Lawrence Moss; 坏死性小肠结肠炎的临床管理。《新生儿评论》。2001;2:e110–7。

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Funding

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Research was supported by the UCLA Children’s Discovery and Innovation Institute (CDI) Resident Research Recognition Award (to LS). Statistical analyses for this project were supported by the National Center for Advancing Translational Science (NCATS) of the National Institutes of Health under the UCLA Clinical and Translational Science Institute (Grant Number UL1TR001881)..

本研究得到了加州大学洛杉矶分校儿童发现与创新研究院（CDI）住院医师研究表彰奖（授予LS）的支持。本项目的统计分析得到了美国国立卫生研究院（NIH）下属的国家转化科学促进中心（NCATS）通过加州大学洛杉矶分校临床与转化科学研究所（UCLA CTSI，资助编号UL1TR001881）的支持。

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Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

加州大学洛杉矶分校大卫·格芬医学院儿科系，洛杉矶，加利福尼亚州，美国

Lisa Soumekh, Samantha Bell & Sandra L. Espinosa

丽莎·苏梅克、萨曼莎·贝尔、桑德拉·L·埃斯皮诺萨

Department of Medicine Statistics Core, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

加州大学洛杉矶分校大卫·格芬医学院医学统计核心，洛杉矶，加利福尼亚州，美国

Tristan Grogan

特里斯坦·格罗根

Department of Pediatrics, Division of Neonatology, University of California Los Angeles, Los Angeles, CA, USA

美国加利福尼亚州洛杉矶市，加州大学洛杉矶分校，儿科系，新生儿科 отделение

Kalpashri Kesavan & Kara L. Calkins

卡拉帕什里·凯萨万和卡拉·L·卡尔金斯

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Lisa Soumekh

丽莎·苏梅克

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Samantha Bell

萨曼莎·贝尔

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Sandra L. Espinosa

桑德拉·L·埃斯皮诺萨

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Tristan Grogan

特里斯坦·格罗根

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Kalpashri Kesavan

卡尔帕什里·凯萨万

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Kara L. Calkins

卡拉·L·卡尔金斯

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Contributions

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All authors contributed to this study and manuscript. Contributions included: Conceptualization, LS, SB, KC, KK; methodology, LS, SB, KC, KK; statistical analysis, TG; first draft of the manuscript, LS; writing, reviewing, and editing subsequent and final draft of the manuscript, LS, TG, KC, KK. All authors reviewed the results, revised the manuscript, and approved the final version..

所有作者均对本研究和手稿做出了贡献。具体贡献包括：概念化，LS、SB、KC、KK；方法论，LS、SB、KC、KK；统计分析，TG；手稿初稿，LS；撰写、审阅和编辑后续及最终稿，LS、TG、KC、KK。所有作者审阅了研究结果，修订了手稿，并批准了最终版本。

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Kara L. Calkins

卡拉·L·卡尔金斯

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Competing interests

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KLC has served as an advisor for Fresenius Kabi and has received research support from Fresenius Kabi. KLC has served as an advisor for Mead Johnson Nutrition and Baxter. KLC serves as an institutional principal investigator, with no salary funding, for a consortium database sponsored by Mead Johnson Nutrition.

KLC 曾担任 Fresenius Kabi 的顾问，并获得过 Fresenius Kabi 的研究支持。KLC 曾担任 Mead Johnson Nutrition 和 Baxter 的顾问。KLC 作为机构主要研究者，参与了一个由 Mead Johnson Nutrition 赞助的联盟数据库项目，未领取任何薪资资助。

KK receives research support from the Cerebral Palsy Foundation..

KK获得脑瘫基金会的研究支持。

Ethics

伦理学

This study was approved by the IRB at University of California Los Angeles. The study was performed in accordance with the Declaration of Helsinki. All methods were performed in accordance with the relevant guidelines and regulations.

本研究已获得加州大学洛杉矶分校伦理审查委员会的批准。研究按照《赫尔辛基宣言》进行。所有方法均按照相关指南和规定执行。

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Soumekh, L., Bell, S., Espinosa, S.L.