Prematüre Bebeklerde Touwen İnfant Nörolojik Değerlendirmesi, General Movements Değerlendirmesi ve Alberta İnfant Skalasının Karşılaştırılması

Abstract

Amaç Prematüre bebeklerin orta ila ciddi gelişimsel sorunlar açısından risk altında olduğu bilinmektedir. Çalışmanın amacı, gestasyonel yaşlarına göre ayrılan prematüre bebeklerin düzeltilmiş 3 ila 5 aylık iken aynı gün içerisinde değerlendirilen Touwen İnfant Nörolojik Değerlendirmesi (TİND), General Movement Değerlendirmesi (GMs) ve Alberta İnfant Motor Skalası (AİMS) skorlarını karşılaştırmaktır. Materyal ve Metot 3-5 ay düzeltilmiş yaşlarında gestasyonel yaşlarına göre erken prematüre (<32 hafta, n = 26), orta prematüre (320/7 ila 336/7 hafta, n = 30) ve geç prematüre (340/7 ila 366/7 hafta, n = 22) olmak üzere toplam 78 prematüre bebek çalışmaya dahil edilmiştir. Çalışmada gestasyonel yaşa göre ayrılan prematüre bebekler arasında TİND, AİMS ve GMs değerlendirmesi sonuçları karşılaştırılmış ve GMs sonuçlarına göre AİMS skorları incelenmiştir. Ayrıca TİND ve AİMS skorları arasındaki ilişki de değerlendirilmiştir. Bulgular AİMS sonuçlarına göre; grupların yüzüstü motor performansları arasında geç prematüre bebekler ile erken prematüre bebeklerden kaynaklanan bir fark bulundu; geç prematüre bebeklerin yüzüstü motor performansı erken prematüre bebeklerden daha yüksekti. GMs değerlendirmesine göre; normal fidgety hareketleri görülen bebeklerin AİMS’ten aldıkları yüzüstü (p=0,043) ve sırtüstü (p= 0,037) motor performans skorları, anormal fidgety hareketleri görülen bebeklerden daha yüksekti. TİND ile toplam AİMS skorları arasında negatif düşük bir korelasyon bulundu. Sonuç Sonuç olarak, fidgety hareketleri görülmeyen ya da anormal olan prematüre bebeklerin AİMS skoru yani motor performanslarının daha kötü olduğu ve gestasyonel yaşın AİMS skorunu etkileyebileceği görüldü. Ayrıca, TİND'a göre anormal nörolojik bulgular arttıkça AİMS skorunun düştüğü bulundu.

Keywords

• General movements değerlendirmesi
• Minör nörolojik disfonksiyon
• Prematüre

A Comparison of the Touwen Infant Neurological Examination, General Movement Assessment and Alberta Infant Motor Scale in Infants Born Preterm

Abstract

Objective Infants born preterm are known to be at risk of moderate to severe developmental problems. The study aimed to compare Touwen Infant Neurologic Examination (TINE), General Movement Assessment (GMA) and Alberta Infant Motor Scale (AIMS) scores assessed within one day at 3-to-5 months-of-corrected-age in infants separated by gestational week. Materials and Methods We included a total of 78 infants with a history of preterm birth, as very preterm (<32 weeks, n = 26), moderate preterm (320/7 to 336/7 weeks, n = 30) and late preterm (340/7 to 366/7 weeks, n = 22), at 3 to 5 months-of-corrected-age. The study compared the results of TINE, AIMS and GMA in preterm infants separated by gestational age, and analysed AIMS scores according to GMs results. In addition the association between TINE and AIMS scores was assessed. Results There was statistical significance between the prone motor performances of the groups, due to the statistical difference between infants born late preterm and infants born very preterm; the prone motor performance of infants born late preterm were significantly higher than infants born very preterm. Infants with normal fidgety movements had higher prone (p=0.043) and supine (p= 0.037) motor performance scores than infants with aberrant fidgety movements. A significant negative low correlation was found between TINE findings and total AIMS scores. Conclusions Infants with absent and abnormal fidgety movements have lower AIMS score and GA might affect AIMS score. Additionally, it has been showed that abnormal neurologic findings, according to TINE, are negatively related to AIMS score.

Keywords

• General movements
• Minor Neurological Dysfunction
• Preterm

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