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Updated: May 29, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
General movements and neurodevelopmental outcome at 6 years in extremely preterm born children
Piia Lönnberg1, Marjo Metsäranta2, Irmeli Rajantie3
1Department of Pediatric Neurology, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
Early detection of neurodevelopmental challenges in extremely preterm infants is crucial. Aberrant fidgety movements (FMs) and lower Motor Optimality Scores - Revised (MOS-R) are linked to poorer outcomes at six years.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Movement Science
Background:
- Infants born extremely preterm (EPT) are at high risk for neurodevelopmental challenges.
- Early identification of at-risk infants is essential for timely intervention.
- General Movements (GMs) assessment is a sensitive tool for evaluating early motor repertoire.
Purpose of the Study:
- To evaluate General Movements (GMs) at fidgety age in extremely preterm (EPT) infants.
- To determine if fidgety movements (FMs) and Motor Optimality Scores - Revised (MOS-R) predict neurodevelopmental outcomes at six years of age.
Main Methods:
- A longitudinal cohort study involving 38 EPT infants (< 28 weeks gestation).
- General Movements (GMs) were assessed at three months corrected age using the Prechtl General Movements Assessment.
- Motor Optimality Scores - Revised (MOS-R) were calculated, and neurodevelopmental outcomes (neurological, cognitive, neuropsychological) were assessed at six years.
Main Results:
- 24% of EPT infants exhibited aberrant fidgety movements (FMs).
- Aberrant FMs were significantly associated with lower full-scale intelligence quotient (FSIQ) and impaired auditory attention.
- MOS-R scores showed positive correlations with FSIQ, performance IQ, visuospatial processing, and visual attention.
Conclusions:
- Aberrant fidgety movements (FMs) and lower Motor Optimality Scores - Revised (MOS-R) in EPT infants are associated with adverse neurodevelopmental outcomes at six years.
- These findings highlight the potential of early GM assessment for identifying EPT infants requiring closer monitoring and support.
Background:
Infants born extremely preterm (EPT) face a variety of neurodevelopmental challenges. Those most at risk of adverse outcomes should be detected early.
Aims:
To assess General Movements (GMs) at fidgety age in EPT infants and to investigate whether fidgety movements (FMs) and Motor Optimality Scores - Revised (MOS-R) are associated with neurodevelopmental outcome at six years.
Study Design:
Longitudinal cohort study.
Subjects:
Thirty-eight EPT children (< 28 weeks of gestation, 11 girls).
Outcome Measures:
GMs were assessed from video recordings at three months corrected age using the Prechtl General Movements Assessment and The Motor Optimality Score for 3- to 5-Month-Old Infants - Revised. Neurological (Touwen), cognitive (WPPSI-III) and neuropsychological (NEPSY-II, visuospatial and attention) outcomes were evaluated at six years.
Results:
Nine (24 %) of the infants had aberrant (abnormal/sporadic/absent) FMs and all but one had abnormal movement character. Median MOS-R was 21. Infants with aberrant FMs had significantly higher odds ratio (OR) for full-scale intelligence quotient ≤ 85 (FSIQ, OR 7.7, p = 0.03) and auditory attention ≤ -1SD (OR 12.8, p = 0.04). MOS-R scores correlated positively with FSIQ (Spearman r = 0.39, p = 0.02), performance IQ (r = 0.47, p = 0.004), visuospatial processing (Geometric Puzzles, r = 0.53, p = 0.006) and visual attention (r = 0.29, p = 0.01). Overall outcome or neurological outcome did not reach statistical significance in associations with aberrant FMs or MOS-R.
Conclusion:
Aberrant FMs and lower MOS-R are associated with worse neurodevelopmental outcomes when compared to normal FMs and/or higher MOS-R.
