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Predictive value of definitely abnormal general movements in the general population

Hylco Bouwstra1, Geerteke R Dijk-Stigter, Hedwig M J Grooten

  • 1Beatrix Children's Hospital - Developmental Neurology, University Medical Centre Groningen, 9713 GZ Groningen, the Netherlands.

Developmental Medicine and Child Neurology
|December 17, 2009
PubMed

Insights

General movement assessment in infants can predict neurodevelopmental impairment. However, its predictive value is lower in the general population compared to high-risk groups.

Area of Science:

  • Neonatal neurology
  • Developmental pediatrics
  • Predictive diagnostics

Background:

  • Abnormal general movements in high-risk infants are established predictors of serious neurodevelopmental impairment.
  • The utility of general movement assessment in the general infant population remains less understood.

Purpose of the Study:

  • To evaluate the predictive accuracy of definitely abnormal general movements observed at 3 months of age for identifying serious neurodevelopmental impairment in a general infant population.
  • To determine the positive and negative predictive values of this assessment method in a non-selected cohort.

Main Methods:

  • A prospective cohort study involved 455 infants assessed at 3 months using video-recorded general movement quality.
  • Participants were followed up at 4 years for reassessment of neurodevelopmental status by clinicians.
  • Predictive values for major neurodevelopmental impairment and cerebral palsy were calculated.

Main Results:

  • Five children were diagnosed with major neurodevelopmental disorders, including three with cerebral palsy (CP).
  • Of these, three had shown definitely abnormal general movements, linked to periventricular white matter lesions.
  • The positive predictive value for major neurodevelopmental impairment was 18%, and for CP it was 12%; negative predictive values neared 100%.

Conclusions:

  • The strong predictive capability of general movement assessment seen in high-risk populations does not directly translate to the general infant population.
  • This highlights the need for context-specific interpretation of general movement assessments.
Abstract

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