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Preterm General Movements in Prediction of Neurodevelopmental Disability and Cerebral Palsy at Two Years: A

Hima B John1, Samuel P Oommen2, T O Swathi3

  • 1Department of Neonatology, Christian Medical College, Vellore, Tamil Nadu, India.

Indian Pediatrics
|August 12, 2022
PubMed

Insights

General movements (GM) assessed in preterm infants are less accurate than fidgety movements in predicting neurodevelopmental disability and cerebral palsy (CP). Fidgety movements show higher specificity for identifying these risks in very preterm infants.

Area of Science:

  • Neonatal neurology
  • Developmental pediatrics
  • Movement analysis

Background:

  • Early neurological assessment in NICU can guide interventions for cerebral palsy (CP) and neurodevelopmental disability.
  • Very preterm infants are at high risk for CP and neurodevelopmental sequelae.

Purpose of the Study:

  • To evaluate the predictive accuracy of general movements (GM) during the preterm and fidgety movement periods.
  • To assess GM's ability to predict neurodevelopmental disability and CP in infants born at very preterm gestations (≤32 weeks).

Main Methods:

  • A prospective cohort study included 170 very preterm infants (mean gestation 29.8 weeks).
  • General movements were assessed during the preterm (31-36 weeks post-conception) and fidgety (8-18 weeks post-term) periods.
  • Neurodevelopmental outcomes were evaluated at 18-24 months corrected age using the Griffiths Mental Developmental Scales-2 in 127 infants.

Main Results:

  • Nine infants (7%) exhibited neurodevelopmental disability (2 CP, 7 global developmental delay).
  • Fidgety movements demonstrated higher relative risk (6.07) for neurodevelopmental disability compared to preterm movements (1.46).
  • Predictive accuracy for CP was 100% sensitivity and 93% specificity with fidgety movements, versus 50% sensitivity and 63% specificity with preterm movements.

Conclusions:

  • Fidgety movements are more sensitive and specific predictors of neurodevelopmental disability and CP in very preterm infants than preterm movements.
  • GM assessment, particularly during the fidgety period, offers valuable insights for early identification of neurodevelopmental risks.
Abstract

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