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High prevalence of abnormal motor repertoire at 3 months corrected age in extremely preterm infants
Toril Fjørtoft1, Kari Anne I Evensen2, Gunn Kristin Øberg3
1Dept. of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Norway; Dept. of Lab. Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
Insights
Extremely preterm infants show poorer early motor repertoire compared to term-born infants. These differences persist regardless of ultrasound findings or gestational age, highlighting potential long-term developmental concerns.
Area of Science:
- Neonatal Development
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Extremely preterm infants (ELGAN/ELBW) often exhibit developmental challenges.
- Early motor repertoire is a sensitive indicator of neurological development in infants.
- Understanding motor differences in preterm infants is crucial for early intervention.
Purpose of the Study:
- To compare the early motor repertoire of extremely preterm infants with that of term-born infants.
- To investigate the association between motor repertoire and gestational age/birth weight in preterm infants without severe abnormalities.
Main Methods:
- A multicenter study assessed 82 extremely preterm infants (born <28 weeks and/or <1000g) and 87 term-born infants.
- The Assessment of Motor Repertoire (AMR) was used at 12 weeks post-term to evaluate fidgety and concurrent movements.
- Movement patterns were classified as normal (smooth, fluent) or abnormal (monotonous, stiff, jerky, etc.).
Main Results:
- Significantly higher rates of abnormal fidgety movements (OR: 12.0) and concurrent motor repertoire (OR: 5.3) were observed in preterm infants compared to controls.
- Almost all detailed aspects of the AMR differed between the extremely preterm and term-born groups.
- These motor differences remained consistent even after excluding infants with severe ultrasound abnormalities and showed no correlation with gestational age or birth weight.
Conclusions:
- Extremely preterm infants demonstrate a poorer quality of early motor repertoire compared to their term-born peers.
- The observed motor deficits were not attributable to severe neonatal ultrasound abnormalities or the degree of prematurity.
- Future follow-up studies are needed to determine the long-term consequences of these abnormal early movement patterns.
Aims:
To compare early motor repertoire between extremely preterm and term-born infants. An association between the motor repertoire and gestational age and birth weight was explored in extremely preterm infants without severe ultrasound abnormalities.
Methods:
In a multicentre study, the early motor repertoire of 82 infants born extremely preterm (ELGAN:<28 weeks) and/or with extremely low birth weight (ELBW:<1000 g) and 87 term-born infants were assessed by the "Assessment of Motor Repertoire - 2 to 5 Months" (AMR) which is part of Prechtl's "General Movement Assessment", at 12 weeks post-term age. Fidgety movements were classified as normal if present and abnormal if absent, sporadic or exaggerated. Concurrent motor repertoire was classified as normal if smooth and fluent and abnormal if monotonous, stiff, jerky and/or predominantly fast or slow.
Results:
Eight-teen ELBW/ELGAN infants had abnormal fidgety movements (8 absent, 7 sporadic and 3 exaggerated fidgety movements) compared with 2 control infants (OR:12.0; 95%CI:2.7-53.4) and 46 ELBW/ELGAN infants had abnormal concurrent motor repertoire compared with 17 control infants (OR:5.3; 95%CI:2.6-10.5). Almost all detailed aspects of the AMR differed between the groups. Results were the same when three infants with severe ultrasound abnormalities were excluded. In the remaining ELBW/ELGAN infants, there was no association between motor repertoire and gestational age or birth weight.
Conclusion:
ELBW/ELGAN infants had poorer quality of early motor repertoire than term-born infants.The findings were not explained by severe abnormalities on neonatal ultrasound scans and were not correlated to the degree of prematurity. The consequences of these abnormal movement patterns remain to be seen in future follow-up studies.
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