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Spontaneous motor activity three months after birth in comparison with clinical and ultrasound studies
Ivan S Ivanov1, Krassimir G Shukerski, Elena V Chepisheva
1Department of Pediatrics and Medical Genetics, Medical University-Plovdiv, Bulgaria. ivanovis@plovdiv.techno-link.com
Insights
Assessing fidgety movements in infants is a valuable prognostic tool. Abnormal fidgety movements strongly correlate with neurological and ultrasound abnormalities in newborns, aiding early diagnosis.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Neonatal Assessment
Background:
- The General Movement Assessment, introduced by Prechtl, necessitates further study of spontaneous motor activity.
- Fidgety movements are identified as a key indicator with significant prognostic value.
- Understanding correlations between fidgety movements and established neonatal diagnostic methods is crucial.
Purpose of the Study:
- To prospectively investigate spontaneous motor activity during the fidgety movements period.
- To compare fidgety movement assessments with clinical and ultrasound findings.
- To establish the prognostic value of fidgety movements in infants.
Main Methods:
- Prospective follow-up of 35 infants (0-3 months, including 7 preterm) up to one year of age.
- Fidgety movements assessed between 6-20 weeks corrected age.
- Neurological examination and transfontanel ultrasonography performed at multiple time points.
Main Results:
- 31 infants exhibited normal fidgety movements; 4 had absent fidgety movements.
- High agreement rate (>91%) between normal fidgety movements and mild/absent neonatal abnormalities.
- Absent fidgety movements correlated significantly with severe clinical and ultrasonographic abnormalities.
Conclusions:
- Abnormal fidgety movements show a statistically significant correlation with the severity of neonatal neurological and ultrasonographic abnormalities.
- Fidgety movement assessment is a reliable predictor of neurological status in infants.
- This method enhances early detection and management of developmental disorders.
Unlabelled:
The introduction of the general movement assessment into pediatric practice as a prognostic method (HFR Prechtl, et al., 1997) has prompted the necessity of further, more extended study of spontaneous motor activity. Possible correlations of this method with the well-established diagnostic and prognostic methods in the neonatal and early post-neonatal period need also more extensive study. Fidgety movements seem to be considered the most convenient to study and of the greatest prognostic value.
Objective:
To study prospectively the spontaneous motor activity in the period of fidgety movements and compare it with the results of the clinical and ultrasound methods of investigation.
Material And Methods:
Thirty five infants aged 0 to 3 months (7 preterm infants) referred to the Pediatric Neurology Service at Plovdiv University Clinic of Pediatrics and Medical Genetics for consultation or hospitalisation were prospectively followed up to one year of age. Fidgety movements were examined from six to 20 weeks corrected age; neurologic examination and transfontanel ultrasonography were conducted on the day of an infant's inclusion into the study, during the period of fidgety movements and between 12 to 18 months of age. The clinical and ultrasonographic findings from the neonatal period were analysed.
Results:
Normal fidgety movements were observed in 31 infants; four infants were with absent fidgety movements. The rate of agreement of the results was high (more than 91%, p<0.05) when presence of normal fidgety movements was correlated with absent or mild neonatal and postneonatal neurologic and ultrasonographic abnormalities, and absent fidgety movements with severe clinical and ultrasonographic abnormalities.
Conclusion:
Abnormal fidgety movements are statistically significantly correlated with the grade of neonatal neurologic and ultrasonographic abnormalities and with the clinical and imaging findings during their investigations.
