Related Experiment Videos
Using gross motor milestones to identify very preterm infants at risk for cerebral palsy
1Eudowood Division of Neonatal Medicine, Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD 21205.
Insights
Gross motor milestones effectively screen for cerebral palsy in high-risk preterm infants. Adjusting for preterm birth and using population norms improved screening accuracy, aiding early detection and monitoring.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Motor development assessment
Background:
- Cerebral palsy (CP) is a common cause of motor disability in preterm infants.
- Early detection of CP is crucial for timely intervention and improved outcomes.
- Existing screening tools may have limitations in high-risk preterm populations.
Purpose of the Study:
- To evaluate the efficacy of 10 gross motor milestones as a screening tool for cerebral palsy.
- To assess the impact of corrected-for-gestational-age and population-specific norms on screening performance.
- To determine the utility of incorporating milestone attainment history into routine clinical practice.
Main Methods:
- Prospective study of 173 high-risk infants born at or before 32 weeks gestation.
- Follow-up for 18 to 24 months with assessment of 10 gross motor milestones.
- Analysis of screening efficacy using corrected-for-gestational-age and population norms, including race-specific norms.
Main Results:
- Gross motor milestones demonstrated efficacy in screening for cerebral palsy.
- Correcting for preterm birth and utilizing population norms significantly improved specificity and positive predictive values.
- Race-specific norms did not yield significant improvements in screening accuracy.
Conclusions:
- Gross motor milestone assessment is a valuable tool for screening cerebral palsy in high-risk preterm infants.
- Adjusting for preterm birth and using population norms enhances the reliability of this screening method.
- Integrating milestone monitoring into routine visits can aid healthcare providers in tracking infant development.
Abstract:
The authors evaluated the efficacy of 10 gross motor milestones to screen for cerebral palsy in 173 high-risk, very preterm infants (less than or equal to 32 weeks gestation) followed for 18 to 24 months. Correcting for preterm birth and using population norms led to a better improvement in specificity and positive predictive values; race-specific norms did not contribute significantly. Incorporating a history of milestone attainment into the routine during sequential office visits will help health-care providers to monitor the development of high-risk infants.