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Identification of risk factors in pre-term infants with abnormal general movements
Małgorzata Domagalska-Szopa1, Andrzej Szopa2,3, María Eugenia Serrano-Gómez4,5
1Department of Developmental Age Physiotherapy, Medical University of Silesia, Katowice, Poland.
Insights
Prenatal and postnatal risk factors, including bronchopulmonary dysplasia and maternal infections, are linked to abnormal general movements in preterm infants. These findings aid in predicting neurodevelopmental impairment in newborns.
Area of Science:
- Neonatology
- Neurodevelopmental Pediatrics
- Movement Science
Background:
- Preterm infants face heightened risks for neurodevelopmental impairment (NDI).
- General Movement (GM) Assessment (GMA) during the fidgety period (3-5 months) is crucial for assessing psychomotor development.
- Identifying early risk factors is key to predicting neurological outcomes.
Purpose of the Study:
- To investigate the association between prenatal, perinatal, and postnatal risk factors and General Movement (GM) Assessment outcomes in preterm infants.
- To identify specific risk factors linked to normal, absent, or abnormal fidgety movements (FMs) in preterm newborns.
- To enhance the prediction of neurodevelopmental outcomes in high-risk preterm infants.
Main Methods:
- Utilized the SYNAGIS program to identify risk factors in 164 high-risk preterm infants.
- Assessed infants using the General Movement (GM) Assessment (GMA) during the fidgety period.
- Classified infants into three groups based on GMA: normal FMs, absent FMs, and abnormal FMs.
Main Results:
- Abnormal general movements (GMs) correlate with known factors like birth asphyxia (BA), respiratory distress syndrome (RDS), periventricular leukomalacia (PVL), and intraventricular hemorrhage (IVH) grades 3-4.
- Specific risk factors identified for atypical fidgety movements include bronchopulmonary dysplasia (BPD), infertility treatments, maternal infections, and elevated bilirubin levels.
- Abnormal GMs predict the development of motor impairments in preterm infants.
Conclusions:
- Early identification of risk factors associated with absent or abnormal FMs can aid in predicting neurological outcomes.
- Integrating GMA findings with clinical data offers a more comprehensive approach to assessing neurodevelopmental concerns in preterm infants.
- This study highlights specific, less commonly known risk factors contributing to atypical motor patterns in preterm infants.
Introduction:
This study aimed to investigate the relationship between prenatal, perinatal, and postnatal risk factors for neurodevelopmental impairment (NDI) with the outcomes of General Movement (GM) Assessment (GMA) in pre-term infants at 3-5 months of age. We sought to identify the risk factors associated with the predictors of psychomotor development in pre-term newborns, such as normal fidgety movements (FMs), absent FMs, or abnormal FMs, assessed during the fidgety period of motor development.
Methods:
The SYNAGIS program (prophylactic of Respiratory Syncytial Virus Infection) was used to identify risk factors for the development of neuromotor deficits in 164 pre-term infants who were at high risk of developing these deficits. Based on the GMA, all participants were divided into three groups of infants who presented: (1) normal FMs; (2) absent FMs; and (3) abnormal FMs.
Results:
The results of the current study suggest that abnormal GMs not only indicate commonly known factors like birth asphyxia (BA), respiratory distress syndrome (RDS), periventricular leukomalacia (PVL), intraventricular hemorrhage (IVH) grades 3-4, but also predict the development of motor impairments. In the present study, several specific risk factors including bronchopulmonary dysplasia (BPD), infertility treatments, maternal acute viral/bacterial infections during pregnancy, and elevated bilirubin levels were identified as attributes of an atypical fidgety movement pattern.
Conclusions:
Additional clinical data, such as risk factors for NDI associated with early predictors of psychomotor development in pre-term newborns, i.e., absent or abnormal FMs, may be helpful in predicting neurological outcomes in pre-term infants with developmental concerns in the 1st month of life.
