Predictive Value Of Qualitative Assessment Of General Movements For Adverse Outcomes At 24 Months Of Age In Infants With Asphyxia

According to WHO, 4–9 million newborns develop birth asphyxia each year and at least the same number develop severe consequences such as epilepsy, cerebral palsy and developmental delay. Major manifestations of asphyxia are produced as a result from a combination of hypoxia and ischemia of the brain and other vital organs.It occurs due to combination of vasodilatation and Vasoparalysis[1]. Sequelae of birth asphyxia vary from no ill effects to multiorgan complications and death. This diversity varies with severity and duration of asphyxia and associated with perinatal risk factors[2]. As a result, it is significant to reduce the long-term adverse neurological outcome and reduce the burden on the family and society. However, at home and abroad, there is no unified assessment tool to predict the long-term prognosis of neonatal asphyxia. In recent years, there are many studies on the traditional methods of neural behavior assessment, but there are many defects in the evaluation of the content, complexity, specificity and predictive validity. GMs[3] as an effective tool for early prediction of nervous system outcome in high risk neonates, the whole body movement quality assessment is the basis for the early prediction of the long-term adverse outcomes of neonatal asphyxia. Therefore, the purpose of this study was to investigate the predictive value of GMs in the development of long-term adverse neurological development in term infants with asphyxia.Therefore, research on the following:Objective To study the predictive value of general movements assessment at 24 months in full-term infants with asphyxia.Methods By a retrospectively analytic method,a total of 114 full-term asphyxiated infants who took part in our follow-up after discharged from our neonatal intensive care unit were confirmed as the participants.All of them received GMs assessment during writhing movements period(at least once)and fidgety movements period(at least once) among 3 months. Developmental outcomewas determined after twenty-four months by Bayley Scales of Infant Development(BSID).Results Corrected gestational age in 3 months of GMs quality assessment results:there were 20 cases(17.5%) in the poor repertoire movement.7 cases(6.1%) in the cramped-synchronized movement.8 cases(7%) in the fidgety movements absence. Developmental outcome of Bayley Scales of Infant Development in corrected gestational age in 24 months:7(6.1%) cases with adverse developmental outcomes,6 infants with cerebral palsy and retardation,1 infant with retardation. Predictive validity: Poor Repertoire Movements:validity 78.1%,sensitivity 14.3%,specificity 82.0%, positive predictive value 5.0%,negative predictive value 93.6%,kappa value-0.019(P﹥ 0.05).Cramped-synchronized Movements:validity 98.2%,sensitivity 85.7%, specificity 99.1%,the positive predictive value 85.7%, the negative predictive value99.1%, kappa value 0.848(P ﹤ 0.05).Fidgety Movements absence:validity 97.4%,sensitivity 85.7%,specificity 98.1%,the positive predictive value 75.0%,the negative predictive value99.1%,kappa value 0.786(P﹤0.05).Conclusion Cramped-synchronized Movements and Fidgety Movements absence can effective predict adverse developmental outcomes in full-term infant with asphyxia.Comprehensive assessment of the development of children’s development needs to be combined with the traditional method of behavioral assessment.