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Early detection of general movements trajectories in very low birth weight infants
Matteo Porro1, Camilla Fontana2, Maria Lorella Giannì2,3
1Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Physical Medicine & Rehabilitation Unit, Milan, Italy. matteo.porro@policlinico.mi.it.
Insights
General Movements (GMs) trajectories in preterm infants predict neurodevelopment. Normal or initially poor to normal GM patterns suggest typical development and lower cerebral palsy risk. Abnormal patterns require closer monitoring for early intervention.
Area of Science:
- Neonatology
- Neurodevelopmental Pediatrics
- Movement Science
Background:
- General Movements (GMs) are a key indicator of early brain development.
- Assessing neonatal GM trajectories offers predictive insights into neurodevelopmental outcomes.
- Preterm infants are at higher risk for neurodevelopmental challenges.
Purpose of the Study:
- To investigate General Movements (GMs) neonatal trajectories.
- To determine the association between neonatal GM trajectories and neurodevelopment at three months corrected age (CA) in preterm infants.
Main Methods:
- An observational, longitudinal study was conducted.
- 216 very low birth weight infants were included.
- GMs were recorded at multiple postmenstrual ages and at three months corrected age (CA).
Main Results:
- Persistent Normal (N-N) or Poor Repertoire to Normal (PR-N) GM trajectories were associated with a fidgety pattern at three months CA.
- Persistent Cramped-Synchronized (CS-CS) or Poor Repertoire to Cramped-Synchronized (PR-CS) trajectories showed no fidgety movements at three months CA.
- Normal to Poor Repertoire (N-PR) or persistent Poor Repertoire (PR-PR) trajectories indicated an increased risk (OR 8.43-15.02) of a non-normal fidgety pattern.
Conclusions:
- Neonatal GM trajectories are crucial for predicting infant neurodevelopment.
- N-N or PR-N trajectories suggest normal neurodevelopment and reduced risk of Cerebral Palsy.
- N-PR and PR-PR trajectories necessitate closer follow-up and timely intervention planning.
Abstract:
The aim of the study was to investigate General Movements'(GMs) neonatal trajectories and their association with neurodevelopment at three months corrected age (CA) in preterm infants. We conducted an observational, longitudinal study in 216 very low birth weight infants. GMs were recorded at 31 ± 1, 35 ± 1, 40 ± 1 weeks of postmenstrual age and at three months of corrected age (CA). More than 90% of infants showing neonatal trajectories with persistent Normal (N-N) or initial Poor Repertoire to Normal (PR-N) movements presented fidgety pattern at three months CA. On the contrary, fidgety movements were not detected in any infant with a trajectory of persistent Cramped-Synchronized (CS-CS) or an initial Poor-Repertoire to Cramped-Synchronized (PR-CS) movements. Trajectories with initial Normal to Poor-Repertoire (N-PR) or persistent Poor-Repertoire (PR-PR) movements showed an increased risk of having a non-normal Fidgety pattern compared with the N-N group (OR = 8.43, 95% CI: 2.26-31.45 and OR = 15.02, 95% CI: 6.40-35.26, respectively). These results highlight the importance to evaluate neonatal GMs' trajectory to predict infants' neurodevelopment. N-N or PR-N trajectories suggest normal short-term neurodevelopment, especially a lower risk of Cerebral Palsy; whereas findings of N-PR and PR-PR trajectories indicate the need for closer follow up to avoid delay in programming intervention strategies.
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