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Early motor repertoire and neurodevelopment at 2 years in infants born extremely preterm or extremely-low-birthweight
Amanda K L Kwong1,2,3, Lex W Doyle1,2,4,5, Joy E Olsen1,2
1Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Insights
Early motor assessments in extremely preterm infants can predict later neurodevelopmental outcomes. Poorer scores on the Motor Optimality Score-Revised (MOS-R) and abnormal General Movements Assessment (GMA) at 14 weeks corrected age are linked to cerebral palsy and developmental delays at two years.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Movement science
Background:
- Infants born extremely preterm (<28 weeks' gestation) or extremely-low-birthweight (ELBW) (<1000g) are at high risk for neurodevelopmental impairments.
- Early identification of neurodevelopmental risks is crucial for timely intervention.
Purpose of the Study:
- To investigate the relationship between early motor repertoire and neurodevelopmental outcomes at two years in extremely preterm/ELBW infants.
- To assess the predictive value of the General Movements Assessment (GMA) and Motor Optimality Score-Revised (MOS-R) for neurodevelopmental outcomes.
Main Methods:
- A prospective cohort study of 139 extremely preterm/ELBW infants was conducted.
- Parent-recorded videos were used to score the GMA and MOS-R at 12-13 and 14-15 weeks corrected age.
- Neurodevelopmental outcomes at two years included cerebral palsy diagnosis and scores on the Bayley Scales of Infant and Toddler Development.
Main Results:
- Higher MOS-R scores at 14-15 weeks corrected age were associated with lower odds of cerebral palsy (CP) and motor or cognitive impairment at two years.
- Absent or abnormal GMA at 14-15 weeks corrected age predicted CP and motor delay.
- Early MOS-R scores (12-13 weeks) showed limited association with two-year neurodevelopmental outcomes.
Conclusions:
- Motor repertoire assessments, specifically MOS-R and GMA, at 14-15 weeks corrected age are valuable predictors of neurodevelopmental outcomes in extremely preterm/ELBW infants.
- These findings support the use of early motor assessments for identifying infants at risk for CP and developmental impairments.
Aim:
To determine the relationship between early motor repertoire and 2-year neurodevelopment in infants born extremely preterm (<28 weeks' gestation) or extremely-low-birthweight (ELBW) (<1000g).
Method:
This was a geographical prospective cohort of 139 infants born extremely preterm/ELBW (mean gestational age 26.7 weeks, standard deviation [SD] 2.0, 68/139 [49%] male), with parent-recorded videos suitable for scoring the General Movements Assessment (GMA). Motor repertoire was assessed using the Motor Optimality Score-Revised (MOS-R), with and without the fidgety movement subsection, and the GMA alone at 12 to 13+6 weeks corrected age and 14 to 15+6 weeks corrected age. At 2 years corrected age, impaired development was defined as Bayley Scales of Infant and Toddler Development, Third Edition motor and cognitive development scores 1SD or less relative to controls born at term; paediatricians diagnosed cerebral palsy (CP).
Results:
Greater MOS-R scores at 14 to 15+6 weeks corrected age were associated with lower odds of CP (odds ratio [OR] per 1-point increase=0.83, 95% confidence interval [CI]=0.71-0.99), and motor (OR=0.93, 95% CI=0.87-0.99), or cognitive impairment (OR=0.94, 95% CI=0.88-0.99). Absent/abnormal GMA at 14 to 15+6 weeks was associated with CP and motor delay. There was little evidence that MOS-R scores at 12 to 13+6 weeks were associated with neurodevelopmental outcomes at 2 years.
Interpretation:
Poorer MOS-R scores and absent/abnormal GMA, scored from parent-recorded videos at 14 to 15+6 weeks gestational age, are associated with CP and developmental impairment in 2-year-old infants born extremely preterm/ELBW.
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