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Prediction of long-term neurodevelopmental outcome in preterm infants using trajectories of general movement

Jessie van Dyk1,2, Paige Church3, Sharon Dell4,5

  • 1Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, Canada. Jessie.vandyk@sunnybrook.ca.

Journal of Perinatology : Official Journal of the California Perinatal Association
|July 29, 2018
PubMed

Insights

Assessing general movements quality (AQGM) trajectories in preterm infants helps predict neurodevelopmental impairment. Classifying mildly abnormal assessments as transient injury significantly improves prediction of motor and cognitive outcomes.

Area of Science:

  • Neonatal neurology
  • Developmental pediatrics
  • Movement analysis

Background:

  • Early identification of neurodevelopmental impairment (NDI) in high-risk infants is crucial.
  • General movements assessment (GMA) is a sensitive tool for detecting neurological abnormalities.
  • Predictive value of GMA trajectories in extremely preterm infants requires further investigation.

Purpose of the Study:

  • To evaluate the predictive accuracy of general movements quality (AQGM) trajectories for neurodevelopmental impairment (NDI) at 18-24 months corrected age (CA).
  • To compare the predictive value of different AQGM scoring methods, including a modified approach considering mildly abnormal (MA) assessments as transient.
  • To assess the association of AQGM with neurodevelopmental outcomes measured by the Bayley Scales of Infant Development, Third Edition (BSID-III).

Main Methods:

  • Retrospective cohort study of infants born <30 weeks gestational age and/or birth weight <1500g.
  • AQGM scored at 6 weeks and 3 months CA as normal (N) or abnormal (A).
  • Analysis included persistently abnormal trajectories and a modified AQGM approach classifying MA as normal variant/transient.

Main Results:

  • Persistently abnormal AQGM trajectories predicted NDI (OR 2.5).
  • Using modified AQGM, persistently definitely abnormal (DA) trajectories were linked to significantly lower BSID-III motor and cognitive scores (p<0.001 and p=0.039).
  • Classifying MA assessments as transient injury enhanced the predictive value of AQGM trajectories.

Conclusions:

  • AQGM trajectories are valuable for predicting NDI in high-risk infants.
  • A modified AQGM approach, considering MA as transient, improves prediction of motor and cognitive deficits.
  • This refined assessment aids in identifying infants requiring early intervention.
Abstract

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