Abstract:

Objective　To investigate the application of NBNA and TIMP in the follow-up of preterm infants，and to assess the value of them in early diagnosis of abnormal motor development of preterms. Methods　Databases including Pubmed，Embase and Cochrane Library，China National knowledge internet，and Wanfang data were searched for studies about neuro-behavior or motor assessments with NBNA or TIMP. The methodological quality of the included studies was assessed with COSMIN checklist，then the predictive validity of NBNA and TIMP were compared. Results　Ultimately，16 studies were included，5 of which were about the application of NBNA in follow-up of preterm infants. But many factors might pose threat to methodological quality. As for TIMP，11 studies were included，9 of which showed that with a satisfying predictive validity（sensitivity：0.50 to 1.00；specificity：0.68 to 1.00） or moderate correlation（r：0.36 to 0.44） for the neurodevelopmental scores after half a year old. TIMP is helpful in making early diagnosis for neurodevelopmental disability. Conclusion　With satisfying predictive validity for long-term neurological development outcomes of the preterm infants，TIMP is considered as an alternative method of assessing functional movements in preterms.

Key words: TIMP, preterm, motor development

摘要：

目的　评估新生儿神经行为评分（neonatal behavioral neurological assessment，NBNA）与婴儿运动能力检查（the test of infant motor performance，TIMP）对早产儿运动发育异常的早期诊断价值。方法　检索Pubmed、Embase、Cochrane Library、万方、中国知网数据库，查询从建库至2017-05-20有关早产儿中使用NBNA或者TIMP进行神经行为或运动评估的文献，使用基于共识选择健康测量工具的标准清单（the consensus-based standards for selection of measurement instruments checklist，COSMIN）进行方法学质量评价，并分析NBNA与TIMP的预测效度。结果　最终获得16篇符合标准的文献，其中，5篇关于NBNA在早产儿随访中的应用研究，均存在明显威胁研究的方法学质量的因素；11篇关于TIMP在早产儿随访中的应用研究，其中9篇研究结果示TIMP对纳入早产儿半岁后的神经发育评分有良好的预测效度（灵敏度：0.50～1.00；特异度：0.68～1.00）或相关度（r：0.36～0.44），故TIMP有助于早期诊断。结论　TIMP作为一种功能性运动的评估方法，对早产儿远期神经发育结局具有良好的预测效度。

关键词: 婴儿运动能力检查, 早产儿, 运动发育