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Updated: Jul 13, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Preterm and writhing movements: is it possible to predict fidgety movements in preterm infants?
Felipe A Souza1, Caroline C L Nogueira2, Andrea J Silva3
1Graduate Program in Rehabilitation Sciences and Physical and Functional Performance, Universidade Federal de Juiz de Fora (UFJF), Hospital Regional Dr. João Penido/FHEMIG, Juiz de Fora, MG, Brazil.
Insights
The General Movements Assessment (GMA) at 5 weeks post-term is highly effective in predicting cerebral palsy risk in preterm infants. Early detection through GMA aids in timely intervention for neuromotor development disorders.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Movement analysis
Background:
- Preterm infants lacking fidgety movements at 3 months corrected age face a tenfold increased risk of cerebral palsy.
- The General Movements Assessment (GMA) is a validated method for predicting motor development outcomes.
Purpose of the Study:
- To describe the General Movements Assessment (GMA) trajectory in preterm infants.
- To identify the optimal time point for GMA to predict the fidgety movement period.
Main Methods:
- Fifty-two preterm newborns were assessed using the General Movements Assessment (GMA).
Main Results:
- GMA at 5 weeks post-term demonstrated 86% sensitivity and 58% specificity for predicting neuromotor disorders.
- This assessment yielded a 92% negative predictive value and 69% accuracy.
Conclusions:
- A single GMA near NICU discharge can identify high-risk preterm infants (≤34 weeks gestational age).
- The optimal time for predicting fidgety movements via GMA is 5 weeks post-term.
Background:
Preterm infants who do not have fidgety movements at 3 months of corrected age have up to ten times greater risk of developing cerebral palsy or other alterations in motor development, compared to infants who exhibit such movements. The General Movements Assessment (GMA) is a validated tool that may predict the fidgety movement period.
Objective:
This study aimed to describe the trajectory of the General Movements Assessment (GMA) during the preterm and writhing movements periods in preterm infants and determine the best time point to predict the fidgety movements period.
Study Design:
Fifty-two preterm newborns were evaluated by the GMA method.
Results:
GMA assessment at the age of 5 weeks post term was found the most predictive of neuromotor development disorders in at-risk newborns, with a sensitivity and specificity of 86% and 58%, respectively, and a high negative predictive value (92%) and increased hit ratio (69% accuracy).
Conclusion:
Preterm infants with ≤34 weeks of gestational age have a high prevalence of poor repertoire classifications on the GMA and one single assessment with GMA near the time of NICU discharge seems to be the best time to determine infants who need to be followed more carefully, but the best time point to predict the fidgety movements period was 5 weeks post term.
