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Trajectories of general movements from birth to term-equivalent age in infants born <30 weeks' gestation

Joy E Olsen1, Nisha C Brown2, Abbey L Eeles2

  • 1Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia; The Royal Women's Hospital, Cnr Grattan Street and Flemington Road, Parkville, VIC 3052, Australia.

Early Human Development
|October 30, 2015
PubMed

Insights

General movements (GMs) were predominantly abnormal in very preterm infants before term. However, the proportion of normal GMs increased by term-equivalent age, with postnatal infection being a key associated factor.

Area of Science:

  • Neonatal neurology
  • Developmental pediatrics
  • Movement assessment

Background:

  • General movements (GMs) assessment has strong predictive validity for neurodevelopmental outcomes in preterm infants.
  • Limited data exists on early GM trajectories in very preterm infants before term-equivalent age.

Purpose of the Study:

  • To describe the early general movements (GMs) trajectory from birth to term-equivalent age in very preterm infants (born <30 weeks' gestation).
  • To evaluate the impact of perinatal risk factors on GMs in this population.

Main Methods:

  • A prospective cohort study included 149 very preterm infants (<30 weeks' gestation).
  • General movements (GMs) were assessed weekly until 32 weeks postmenstrual age, then fortnightly until 38 weeks, and again at term-equivalent age.
  • Detailed perinatal data were collected for risk factor analysis.

Main Results:

  • Prior to term, 85% of general movements (GMs) were abnormal, decreasing with postmenstrual age.
  • At term-equivalent age, 30% of GMs were normal.
  • Lower gestational age, postnatal infection, and bronchopulmonary dysplasia were associated with abnormal GMs on univariable analysis.
  • Postnatal infection was the only independent predictor of abnormal GMs on multivariable analysis.
  • All infants with severe intraventricular hemorrhage (IVH) exhibited persistently abnormal GMs.

Conclusions:

  • General movements (GMs) are predominantly abnormal in very preterm infants early in life.
  • An increased proportion of normal GMs is observed by term-equivalent age.
  • Abnormal GMs are significantly associated with postnatal infection and intraventricular hemorrhage (IVH).
Abstract

Keywords:
General movementsPerinatal variablesPostmenstrual ageTerm-equivalent ageVery preterm infants

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