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Prognostic value of the qualitative assessments of general movements in late-preterm infants
Claudia Brogna1, Domenico M Romeo, Chiara Cervesi
1Paediatric Neurology Unit, Catholic University, Rome, Italy.
Insights
General movements (GMs) quality effectively predicts neurodevelopmental outcomes in late-preterm infants. Early GM assessment, particularly during the fidgety period, shows high sensitivity and specificity for identifying cerebral palsy (CP) risk.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Movement science
Background:
- General movements (GMs) quality and predictive value remain unevaluated in late-preterm (LP) infants.
- LP infants represent a significant population at risk for neurodevelopmental disparities.
Purpose of the Study:
- To characterize GMs in LP infants.
- To assess the predictive value of GMs for neurodevelopmental outcomes.
- To establish the utility of GMs for early identification of neurological abnormalities.
Main Methods:
- A cohort of 574 LP infants (34–36 weeks' gestation) was studied.
- Standard Prechtl's method was used to assess GMs during writhing and fidgety periods.
- Neuromotor and developmental assessments were performed at 2 years of age.
Main Results:
- Significant correlations were observed between GM quality and neurodevelopmental outcomes (writhing: rs 0.68; fidgety: rs 0.78).
- GM assessment at 1 month predicted cerebral palsy (CP) with 100% sensitivity and 86% specificity.
- GM assessment at 3 months predicted CP with 100% sensitivity and 97% specificity.
Conclusions:
- GMs, especially during the fidgety age, are highly sensitive and specific predictors of CP in LP infants.
- Qualitative GM assessment is a valuable tool for identifying LP infants needing early intervention for neurological issues.
Background:
The quality of general movements (GMs) and its predictive value have never been evaluated in late-preterm (LP) infants.
Aims:
To determine the characteristics of GMs and their predictive value for neurodevelopmental outcome in a cohort of infants born between 34 and 36 weeks' gestation.
Study Design And Subjects:
574 LP infants were examined using the standard methodological principles of Prechtl's method for assessing GMs both during writhing and fidgety periods.
Outcome Measures:
Infants were assessed at 2 years of age with neuromotor and developmental scales.
Results:
A significant correlation was found between GMs and outcome both at writhing (rs 0.68; p < 0.001) and at fidgety age (rs 0.78; p < 0.001). The assessment at 1 month showed 100% sensitivity and 86% specificity of predicting the development of cerebral palsy (CP), that at 3 months was 100% sensitivity and 97% specificity.
Conclusions:
During the fidgety age GMs predict CP with very high sensitivity and specificity. The qualitative assessment of GMs should be employed to help identify LP infants who require early intervention for neurological abnormalities.
