摘要目的:探讨全身运动细化评分（general movement optimality score，GMOS）在中晚期早产儿脑室周围-脑室内出血（periventricular-intraventricular hemorrhage，PIVH）神经功能动态评估中的应用价值。方法:选择2023年10月至2024年3月江苏省苏北人民医院新生儿科收治的出生胎龄32～36 +6周的中晚期早产儿进行前瞻性研究，根据头颅影像学结果分为PIVH组和非PIVH组，比较两组早产儿在第一阶段校正胎龄38~40周和第二阶段校正3~4月龄时全身运动（general movements，GMs）整体评估和GMOS的差异，分析不同阶段GMOS分值与校正6月龄Gesell评估之间的关系，探讨GMOS在中晚期早产儿PIVH神经功能动态评估方面的应用价值。 结果:共纳入71例中晚期早产儿，其中PIVH组25例，非PIVH组46例。PIVH组胎龄（ P=0.003）和出生体重（ P=0.019）低于非PIVH组，两组分娩方式、性别、多胎、小于胎龄儿、窒息复苏和母亲妊娠期并发症比例的差异无统计学意义（ P>0.05）。两组第一阶段和第二阶段GMs整体评估结果比较均无统计学差异（ P>0.05）；PIVH组第一阶段GMOS分值低于非PIVH组（ P=0.001），两组第二阶段GMOS分值差异无统计学意义（ P>0.05）。PIVH组校正6月龄的Gesell评估中大运动、精细运动、语言、个人-社交评分均低于非PIVH组（ P<0.05）。第一、第二阶段的GMOS分值与校正6月龄时的适应性、大运动、精细运动、语言、个人-社交能区存在相关性（ P<0.05）。 结论:GMOS在中晚期早产儿PIVH的神经功能早期评价及预后评估中均具有一定的应用价值，适用于中晚期早产儿PIVH神经功能的动态评估。

abstractsObjective:To study the clinical value of general movement optimality score (GMOS) in the dynamic assessment of neurological functions in mid-to-late preterm infants with periventricular-intraventricular hemorrhage (PIVH).Methods:From October 2023 to March 2024, mid-to-late preterm infants with gestational age (GA) 32-36 +6 weeks admitted to the Neonatology Department of our hospital were prospectively studied. They were assigned into PIVH group and non-PIVH group according to cranial imaging results. The differences of general movements (GMs) and GMOS were compared between the two groups at corrected GA of 38-40 weeks (Stage1) and corrected age of 3-4 months (Stage2). The correlations of GMOS scores at Stage1 and Stage2 and Gesell developmental schedules (GDS) at corrected age of 6 months were evaluated. Results:A total of 71 mid-to-late preterm infants were enrolled, including 25 in the PIVH group and 46 in the non-PIVH group. The PIVH group had lower GA ( P=0.003) and birth weight (BW) ( P=0.019) than the non-PIVH group. No significant differences existed between the two groups in the following items: mode of delivery, gender, multiple births, incidences of small for gestational age (SGA), resuscitation of asphyxia and pregnancy complications of the mothers ( P>0.05). No significant differences existed in the overall assessment of GMs in stage1 and stage2 between the two groups ( P>0.05). The PIVH group had lower GMOS score in stage1 than the non-PIVH group ( P=0.001) and no significant difference in stage2 between the two groups ( P>0.05). At corrected age of 6 months, the PIVH group showed lower scores in gross motor, fine motor, language and personal-social interactions of GDS than the non-PIVH group (all P<0.05). GMOS scores in stage1 and stage2 were correlated with GDS at corrected age of 6 months in adaptability, gross motor, fine motor, language and personal-social interactions ( P<0.05). Conclusions:GMOS is useful in early and dynamic evaluation of neurological functions and prognostic assessment of PIVH in mid-to-late preterm infants.