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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
General Movements Assessment of infants in the neonatal intensive care unit following surgery
Cathryn Crowle1,2, Nadia Badawi1,2,3, Karen Walker1,2,3
1Grace Centre for Newborn Care, The Children's Hospital Westmead, Sydney, New South Wales, Australia.
Insights
The General Movements (GMs) Assessment is used to identify risk in infants post-surgery. Post-surgical infants most commonly show poor repertoire writhing movements, indicating a need for further research.
Area of Science:
- Neonatal surgery
- Developmental pediatrics
- Movement assessment
Background:
- The General Movements (GMs) Assessment is a validated tool for evaluating neurodevelopmental disorders in infants.
- There is a lack of research on the application of the GMs Assessment in infants following surgical procedures.
Purpose of the Study:
- To investigate the utility of the General Movements (GMs) Assessment in identifying risk profiles in infants after surgery.
- To characterize common writhing movement patterns in this specific population.
Main Methods:
- A prospective cohort study involving 170 infants (99 male) admitted to a neonatal surgical unit.
- Writhing General Movements (GMs) were assessed at term age in infants who underwent cardiac (n=84) or non-cardiac surgery (n=86).
- Assessments were conducted by three trained professionals and categorized according to established criteria.
Main Results:
- Normal writhing movements were observed in 38% of the infants.
- The most frequent movement profile identified was poor repertoire (47%), followed by cramped synchronised movements (8%).
- No significant differences in GMs scores were found between infants who had cardiac surgery compared to those who had non-cardiac surgery (P=0.45).
Conclusions:
- This study presents the first report on the General Movements (GMs) assessment in a post-surgical infant cohort.
- Infants undergoing surgery commonly exhibit poor repertoire writhing movements.
- Further research is warranted to establish the predictive value of GMs for neurodevelopmental outcomes in surgically treated infants.
Aim:
There is an identified gap in the literature regarding the use of the General Movements (GMs) Assessment to identify risk in infants post-surgery. This paper aims to examine the GMs for infants who have undergone surgery to identify common risk profiles in the writhing age.
Methods:
This was a prospective cohort study of 170 infants (99 male, 58%) admitted to a neonatal surgical unit from 2012 until June 2014. Infants were born at a mean age of 38 weeks (standard deviation (SD) 2.3), and writhing GMs were conducted at term (40 weeks, SD 2.6) following either cardiac (n = 84, 49%) or non-cardiac surgery (n = 86, 51%). GMs were categorised by three trained assessors.
Results:
Normal writhing was recorded in 64 infants (38%). The most common profile was poor repertoire (n = 80, 47%), with 14 (8%) cramped synchronised. There was no difference in scores between infants who had undergone cardiac versus non-cardiac surgery (P = 0.45).
Conclusion:
This is the first report on the GMs assessment in an infant surgical population. Infants who have undergone surgery most commonly display poor repertoire writhing movements. Research is needed to determine the ability of the GMs to predict neurodevelopmental outcomes in this population.
