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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
General movements in healthy full term infants during the first week after birth
Wieteke M Ploegstra1, Arend F Bos1, Nathalie K S de Vries2
1Department of Paediatrics, Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, The Netherlands.
Insights
Healthy newborns often exhibit abnormal general movements (GMs) and lower motor optimality scores (OS) in the first week of life. GM quality and OS normalize by day 5-7, regardless of delivery mode.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Movement analysis
Background:
- General movements (GMs) are crucial for assessing neurological function in infants.
- The impact of the birth process on early motor development in healthy newborns remains unclear.
Purpose of the Study:
- To evaluate the quality of general movements (GMs) and motor optimality scores (OS) in healthy full-term infants during their first week.
- To investigate if the mode of delivery influences GM quality in newborns.
Main Methods:
- Video recordings of 33 healthy full-term infants within the first week post-birth.
- Assessment of GM quality and calculation of OS using Prechtl's method.
- Comparison between infants born vaginally and via Cesarean section (CS) under spinal anesthesia.
Main Results:
- Abnormal GMs were prevalent in early recordings (days 0-2), with rates of 86% on day 0 and 94% on day 1.
- Motor optimality scores (OS) significantly improved from a median of 12 on day 0 to 18 by days 5-7.
- No significant differences in GM quality or OS were found between infants delivered vaginally or by CS.
- Monotonously slow movements decreased significantly from early days to days 5-7.
Conclusions:
- Healthy full-term infants frequently display suboptimal GM quality and lower OS in the initial postnatal week.
- GM quality and OS demonstrate normalization within the first week, particularly by days 5-7.
- The mode of delivery (vaginal vs. CS) does not appear to affect early GM quality or OS in healthy newborns.
Background:
The quality of general movements (GMs) is a widely used criterion to assess neurological dysfunction in young infants. It is unknown, however, whether the birth process influences the motor repertoire of healthy full term infants during the first week after birth.
Aims:
To assess the quality of GMs and to determine the motor optimality score (OS) in healthy full term infants during the first week after birth and to evaluate the influence of the mode of delivery on GM quality.
Study Design:
Thirty-three healthy full term infants born either vaginally or after caesarean section (CS) under spinal anaesthesia were video recorded in the first week after birth in order to assess GM quality and to determine OS with Prechtl's method.
Results:
Abnormal GMs were observed mainly on the early recordings: 86% on the day of birth (day 0), 94% on day 1, and 68% on day 2. On days 5 to 7 (day 5-7) all GMs were normal (P<.001). The OSs increased significantly from median 12 on day 0 to 18 on day 5-7 (P<.001). Monotonously slow movements were frequently seen during the first days but not on day 5-7 (P<.001). GM quality and OS did not differ between infants born by vaginal delivery or after CS under spinal anaesthesia.
Conclusions:
Healthy full term infants often showed abnormal GM quality and lower OSs during the first week after birth, irrespective of the mode of delivery. GM quality normalised during subsequent days and was normal on day 5-7.
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