Abstract：
Atypical cries have been identified in infants with neurological dysfunction. The aim of this study was to conduct a systematic review and meta-analysis to appraise existing evidence for associations between acoustic cry characteristics and neurological dysfunction in infants aged 18 months or less.
PubMed/MEDLINE, PsycINFO, CINAHL, and Embase were searched for original, peer-reviewed studies published in English reporting cry variables in infants aged 18 months or less with or at risk of neurological dysfunction. Studies without a nonneurologically impaired control sample were excluded. Pooled effect sizes were estimated using standardized mean difference (SMD) and odds ratio (OR). I2 indicated study heterogeneity, and the risk of bias was assessed using the Newcastle-Ottawa Scale.
From March 2018 to February 2019, 28,294 studies were retrieved. Eight were meta-analyzed. Infants with or at risk of neurological dysfunction exhibited higher mean (SMD = 0.11 [95% confidence interval, 0.00 to 0.23]) and minimum (SMD = 0.93 [0.64 to 1.23]) fundamental frequency; higher odds of hyperphonation (OR = 13.17 [1.05 to 165.87]), biphonation (OR = 10.62 [1.53 to 73.59]), rise-fall-rise melodies (OR = 4.66 [1.16 to 18.66]), and flat melodies (OR = 4.47 [1.27 to 15.68]); and lower odds of fall-rise-fall melodies (OR = 0.21 [0.05 to 0.83]).
Infants with underlying neuropathology have unique cries characterized by higher fundamental frequency, dysphonation, and atypical melodies, although study heterogeneity and imprecision of effect size estimates limited our interpretation. Assessment of acoustic cry characteristics offers the potential for noninvasive, rapid, point-of-care screening for neurologically high-risk infants.
PubMed/MEDLINE, PsycINFO, CINAHL, and Embase were searched for original, peer-reviewed studies published in English reporting cry variables in infants aged 18 months or less with or at risk of neurological dysfunction. Studies without a nonneurologically impaired control sample were excluded. Pooled effect sizes were estimated using standardized mean difference (SMD) and odds ratio (OR). I2 indicated study heterogeneity, and the risk of bias was assessed using the Newcastle-Ottawa Scale.
From March 2018 to February 2019, 28,294 studies were retrieved. Eight were meta-analyzed. Infants with or at risk of neurological dysfunction exhibited higher mean (SMD = 0.11 [95% confidence interval, 0.00 to 0.23]) and minimum (SMD = 0.93 [0.64 to 1.23]) fundamental frequency; higher odds of hyperphonation (OR = 13.17 [1.05 to 165.87]), biphonation (OR = 10.62 [1.53 to 73.59]), rise-fall-rise melodies (OR = 4.66 [1.16 to 18.66]), and flat melodies (OR = 4.47 [1.27 to 15.68]); and lower odds of fall-rise-fall melodies (OR = 0.21 [0.05 to 0.83]).
Infants with underlying neuropathology have unique cries characterized by higher fundamental frequency, dysphonation, and atypical melodies, although study heterogeneity and imprecision of effect size estimates limited our interpretation. Assessment of acoustic cry characteristics offers the potential for noninvasive, rapid, point-of-care screening for neurologically high-risk infants.
摘要：
在患有神经功能障碍的婴儿中已经发现了非典型的哭声。这项研究的目的是进行系统评价和荟萃分析，以评估18个月或以下婴儿的声音哭声特征与神经功能障碍之间关联的现有证据。
PubMed/MEDLINE,PsycINFO,CINAHL,Embase被搜索原始的，以英文发表的同行评审研究报告了18个月或以下有神经功能障碍或有神经功能障碍风险的婴儿的哭声变量。没有非神经系统受损对照样品的研究被排除。使用标准化平均差异（SMD）和比值比（OR）估计汇总效应大小。I2表示研究异质性，使用纽卡斯尔-渥太华量表评估偏倚风险。
从2018年3月到2019年2月，共检索了28,294项研究。其中8项进行了荟萃分析。有神经功能障碍或有神经功能障碍风险的婴儿表现出更高的平均值(SMD=0.11[95%置信区间，0.00至0.23]）和最小（SMD=0.93[0.64至1.23]）基频；更高的超音几率（OR=13.17[1.05至165.87]），双声（OR=10.62[1.53至73.59]），上升-下降-上升旋律（OR=4.66[1.16至18.66]），和平坦的旋律（OR=4.47[1.27至15.68]）；下降-上升-下降旋律的几率较低（OR=0.21[0.05至0.83]）。
具有潜在神经病理学的婴儿有独特的哭声，其特征是基频较高，发音困难,和非典型的旋律，尽管研究的异质性和效应大小估计的不精确性限制了我们的解释。声学哭声特性的评估提供了非侵入性，快速,神经系统高危婴儿的即时筛查。
PubMed/MEDLINE,PsycINFO,CINAHL,Embase被搜索原始的，以英文发表的同行评审研究报告了18个月或以下有神经功能障碍或有神经功能障碍风险的婴儿的哭声变量。没有非神经系统受损对照样品的研究被排除。使用标准化平均差异（SMD）和比值比（OR）估计汇总效应大小。I2表示研究异质性，使用纽卡斯尔-渥太华量表评估偏倚风险。
从2018年3月到2019年2月，共检索了28,294项研究。其中8项进行了荟萃分析。有神经功能障碍或有神经功能障碍风险的婴儿表现出更高的平均值(SMD=0.11[95%置信区间，0.00至0.23]）和最小（SMD=0.93[0.64至1.23]）基频；更高的超音几率（OR=13.17[1.05至165.87]），双声（OR=10.62[1.53至73.59]），上升-下降-上升旋律（OR=4.66[1.16至18.66]），和平坦的旋律（OR=4.47[1.27至15.68]）；下降-上升-下降旋律的几率较低（OR=0.21[0.05至0.83]）。
具有潜在神经病理学的婴儿有独特的哭声，其特征是基频较高，发音困难,和非典型的旋律，尽管研究的异质性和效应大小估计的不精确性限制了我们的解释。声学哭声特性的评估提供了非侵入性，快速,神经系统高危婴儿的即时筛查。
