| Objectives To know what's the high risk newborns' neurological and psychological outcomes. To investigate the predictive value of 5 Vojta postural reflexes, 7 motor milestones and plantar grasp reflex for the later development of neurological and psychological deficits. For the first time in china, to evaluate whether abnormal fidgety movements can predict cerebral palsy (CP) and developmental retardation in young infants.Methods The subjects were the 86 infants hospitalized in Anhui Provincal Child's Hospital from February to July in 2004 due to asphyxia of newborn, hypoxic-ischemic encephalopathy (HIE), intracranial haemorrhage, hyperbilirubinemia, preterm or low birth weight. We got information about their birth condition, newborn disease, computerized tomography (CT) during newborns and their parental demographic characteristics from case files or interview. Then the data was collected on birth defects, 5 Vojta postural reflexes (traction reflex. Landau reflex, Axillar vertical reflex, vojta reflex, Collis horizontal reflex), 7 motor milestones and plantar grasp reflex from birth to 6-9 months old. At the first time. We collected signs from babies when they were in the hospital after their diseases were controlled or when they were out of the hospital by following. Among them, 69 of 86 infants from 46 weeks to 60 weeks of postmenstrual age (PMA) were videoed for fidgety movements (FMs) several times, and it lasted 5-10 minutes each time. In the end, we analyzed prospectively the relation between these signs and the assessments of neurological and mental development at the age of 6-9 months.Results The developmental outcomes were evaluated in 86 infants when they were 6-9 months old. Seven of 86 infants were diagnosed as CP, and these 7 infants were diagnosed as mental developmental retardation (MDR) and psychomotor developmental retardation (PDR) at the same time. The other 79 infants were not diagnosed as CP, however, 12 infants of them were diagnosed as MDR and PDR, 5 infants were diagnosed as MDR or PDR with mental development borderline or psychomotor development borderline, 2 infants were diagnosed as only MDR or PDR, 52 infants were diagnosed as normal.The incidence of birth defects was higher among these high risk newborns whose mental or psychomotor developmental outcomes were retardation or borderline than those high risk newborns whose mental or psychomotor developmental outcomes were normal. From birth to 6-9 months, there were significant correlation between three or more abnormal Vojta postural reflexes (PR) and CP; and still more, there were rank correlation between the number of abnormal PR and the abnormal neurological and mental outcomes: the more the number of abnormal PR, the worse the neurological and mental outcomes. There was significant difference of motor milestone scores between neurological and mental normal infants and abnormal ones from the 1st month of life (P<0.05). Only 3 of 22 infants who showed abnormal plantar grasp response had normal neurological and mental outcomes, 5 infants were diagnosed as CP, 12 infants were diagnosed as MDR or PDR, 2 infants were diagnosed as mental development borderline or psychomotor development borderline. 49 of 64 infants who showed normal plantar grasp response had normal neurological outcomes, 2 infants were diagnosed as CP, 7 infants were diagnosed as MDR or PDR, 6 infants were diagnosed as mental developmental borderline or psychomotor developmental borderline. The difference between the two groups was significant (P=0.000). Twenty one of the 26 infants who showed abnormal quality of fidgety movements were diagnosed as MDR or PDR, and 5 of them were diagnosed as CP at the same time; 2 had normal MDI, but borderline of... |
PDF Full Text Request