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Upper limb movements and outcome in intrauterine-growth-retarded infants at 2 years
Luba Zuk1, Shaul Harel, Yael Leitner
1Physical Therapy Department, Spayer School for Allied Sciences, Sackler Faculty of Medicine, Tel Aviv University, Israel. lubazuk@post.tau.ac.il
Insights
Spontaneous upper limb movements (ULM) in infants with intrauterine-growth retardation (IUGR) can predict neurodevelopmental outcomes. Suboptimal ULM scores in IUGR infants indicate a higher risk for abnormal development at two years.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Movement analysis
Background:
- Intrauterine-growth retardation (IUGR) is associated with increased risk of adverse neurodevelopmental outcomes.
- Early detection of brain dysfunction in infants is crucial for timely intervention.
- General Movements (GMs) assessment is a validated method for early neurodevelopmental screening.
Purpose of the Study:
- To evaluate the utility of spontaneous upper limb movements (ULM) as an early predictive marker for neurodevelopmental outcomes in infants with IUGR.
- To compare ULM in infants with IUGR versus appropriate-for-gestational-age controls.
- To correlate ULM scores with neurodevelopmental assessments at two years of age.
Main Methods:
- A cohort of 32 infants with IUGR and 32 matched controls were studied.
- Spontaneous upper limb movements (ULM) were assessed via videotape recordings during the writhing, early fidgety, and late fidgety periods.
- ULM were scored as optimal or suboptimal and correlated with neurodevelopmental scores at 2 years.
Main Results:
- Infants with IUGR exhibited significantly lower mean ULM scores compared to controls.
- Lower ULM scores within the IUGR group were associated with abnormal neurodevelopmental outcomes at two years.
- ULM scores, particularly during the late fidgety period, showed significant correlations with 2-year neurodevelopmental outcomes.
Conclusions:
- Spontaneous upper limb movements (ULM) serve as a valuable early predictor of neurodevelopmental outcomes in infants with intrauterine-growth retardation (IUGR).
- The assessment of ULM provides a non-invasive method for identifying infants at risk for developmental abnormalities.
- ULM analysis, especially during the late fidgety period, offers prognostic information for neurodevelopmental trajectories in IUGR infants.
Abstract:
This study aims to examine the usefulness of spontaneous upper limb movements (ULM) as an early marker for predicting neurodevelopmental outcome in infants with intrauterine-growth retardation (IUGR). The assessment of general movements (GMs) during the first 20 weeks is an accepted method for early detection of brain dysfunction. During this period, spontaneous upper limb movements were examined in 32 infants with IUGR and 32 appropriate-for-gestational-age-matched controls. ULM (arms, forearms and hands) were scored as optimal or suboptimal by sequential videotape recordings in the writhing (term-2 weeks: score 0-5); early fidgety (9-11 weeks: score 0-6); and late fidgety (14-16 weeks: score 0-6) periods, and correlated with neurodevelopmental score at 2 years of age. The mean ULM score was lower in the IUGR infants than the controls (p<0.05) and in the IUGR group was lower in the infants with abnormal outcome (p<0.05). Significant correlations were found between ULM and 2-year neurodevelopmental scores in the IUGR group. The ULM during late-fidgety period was most predictive for 2-year neurodevelopmental score. No difference was found in the mean ULM score between the pre-term and term IUGR infants. We conclude that ULM score can serve as an early predictor for neurodevelopmental outcome at 2 years of age in infants with IUGR.
