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Updated: Jun 4, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Comparative analysis of perinatal and postnatal factors, and general movement in extremely preterm infants
Meriem Zahed-Cheikh1, Véronique Brévaut-Malaty, Muriel Busuttil
1Department of Paediatrics, Hôpital Nord, Université de la Méditerranée, Chemin des Bourellys, 13015 Marseille Cedex 20, France. zahedmeriem@yahoo.fr
Insights
General movements in extremely premature infants are variable and can indicate health issues. Writhing movements correlate with postnatal morbidities like chronic lung disease and infections, while later movement quality predicts neurological outcomes.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Movement analysis
Background:
- General movements (GMs) are crucial indicators of neurological development in infants.
- Extremely premature infants present unique challenges in assessing motor development due to their immaturity.
- Understanding GMs' correlations with morbidities is vital for early intervention.
Purpose of the Study:
- To describe general movement patterns in extremely premature infants.
- To investigate the relationship between GMs and antenatal, perinatal, and postnatal risk factors.
- To assess the predictive value of GMs for neurological outcomes.
Main Methods:
- Prospective, single-center study involving 19 extremely premature infants.
- Video analysis of general movements during the writhing movement (WM) and fidgety movement (FM) periods.
- Qualitative and quantitative assessments correlated with clinical data.
Main Results:
- Infant motor activity fluctuated during the WM period, with poor repertoire observed in extremely premature infants.
- WM quality correlated with gestational age and postnatal morbidities, including chronic lung disease (CLD) and nosocomial infections.
- Spontaneous movement quality at 3 months corrected age correlated with neurological assessments (US brain, MRI, EEG) and follow-up.
Conclusions:
- Analysis of general movements in extremely premature infants requires careful interpretation.
- WMs can be influenced by perinatal factors and brain immaturity, correlating with CLD and infections.
- Assessing GMs at 3 months corrected age is valuable for detecting neurological disorders in these infants.
Study Aim:
To describe general movement in extremely premature infants and examine correlations with risk factors for antenatal, perinatal, and postnatal morbidity.
Study Type:
Prospective, single-center study. Nineteen patients were followed up.
Methodology:
The infants' general movement was analyzed using video recordings. Qualitative and quantitative assessments were performed during the writhing movement (WM) period and fidgety movement (FM) period. The quality of the general movements (GMs) and the scores achieved were then correlated with antenatal, perinatal, and postnatal factors.
Results:
Infants' motor activity fluctuated during the WM period, especially in extremely premature infants where poor repertoire is often observed. No correlations were found between WMs and obstetric factors. Gestational age correlated with WMs' quality (p=0.023). WMs correlated with factors of postnatal morbidity such as chronic lung disease (CLD) (p=0.034) and nosocomial infections (p=0.05). At 3 months corrected age, the spontaneous movement quality are correlated with neurological explorations such as US brain (p=0.032), MRI (p=0.039), EEG (p=0.036), and neurological follow-up assessments (p=0.015).
Conclusion:
Prudence must be used when performing the analysis of general movement in extremely preterm infants. WMs may be influenced by perinatal morbidity, and possibly by the severe brain immaturity of these infants. WMs correlate with CLD and nosocomial infections. Analysis of general movement in infants of 3 months corrected age is a valuable means to detect neurological disorders.
