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Prevalence of abnormal general movements in three-month-old infants
Hylco Bouwstra1, Geerteke R Dijk-Stigter, Hedwig M J Grooten
1Department of Paediatrics - Developmental Neurology, University Medical Center Groningen, Groningen, The Netherlands.
Insights
The prevalence of definitely abnormal general movements (GMs) in three-month-old infants is 3.7%, with these cases linked to preterm birth and maternal smoking during pregnancy. Mildly abnormal GMs affect 25% of infants.
Area of Science:
- Pediatric neurology
- Developmental pediatrics
- Movement analysis
Background:
- General movements (GMs) are a sensitive indicator of neurodevelopmental status in infants.
- Prevalence rates of abnormal GMs in the general infant population are not well-established.
Purpose of the Study:
- To determine the prevalence of abnormal general movements (GMs) in three-month-old infants.
- To investigate associations between abnormal GM quality and medical/social risk factors.
Main Methods:
- Video-taping and expert assessment of GMs in 455 infants aged 2-4 months.
- Classification of GM quality into normal optimal, normal suboptimal, mildly abnormal, and definitely abnormal categories.
- Analysis of social, perinatal, and postnatal factors associated with abnormal GMs using regression models.
Main Results:
- Definitely abnormal (DA) GMs were observed in 3.7% of infants, while mildly abnormal (MA) GMs were found in 25%.
- DA GMs were significantly associated with preterm birth and maternal smoking during pregnancy.
- Abnormal (DA+MA) GMs were linked to preterm birth, lower paternal profession level, and urban living.
Conclusions:
- The prevalence of definitely abnormal GMs in the general infant population is 3.7%.
- Mildly abnormal GMs are more common, affecting 25% of infants.
- Clinically significant abnormal GMs are associated with specific adverse perinatal and social factors.
Background:
The quality of general movements (GMs) is a sensitive tool to measure neurodevelopmental condition in early infancy. No information is available on prevalence rates of abnormal GMs in the general population.
Objective:
To assess the prevalence of abnormal GMs in the general population of three-month-old infants and to evaluate the association of abnormal GM quality with medical and social risk factors.
Method:
We recruited 535 infants in six well baby clinics in The Netherlands. GMs were video-taped at the corrected age of 2 to 4 months. GM-quality was assessed by two persons unaware of the infant's history. GM-quality was classified as normal optimal (NO), normal suboptimal (SO), mildly abnormal (MA) and definitely abnormal (DA). Only the last category implies clinically relevant dysfunction. Social, perinatal and postnatal characteristics were collected and their association with DA and abnormal (DA+MA) GMs were evaluated by means of univariate and logistic regression analyses.
Results:
GM-quality could be assessed reliably in 455 infants (85%). Seventeen infants (3.7%) showed DA GMs and 113 (25%) MA GMs. DA GMs were associated with preterm birth and smoking during pregnancy; abnormal (DA+MA) GMs with preterm birth, a relatively low level of paternal profession and urban living conditions. These factors explained between 3% and 7% of variance.
Conclusion:
The study indicates that the prevalence of definitely abnormal GMs in the general population is 3.7% and that of mildly abnormal GMs 25%. The clinically relevant definitely abnormal GMs were associated with preterm birth and smoking during pregnancy.
