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Writhing Movements and Hypoglycemia in Moderate-Late Preterm Infants: A Prospective Cohort Study

Javier Merino-Andrés1,2, Francisco Javier Fernández-Rego3,4, Álvaro Hidalgo-Robles5

  • 1Toledo Physical Therapy Research Group (GIFTO), Faculty of Physical Therapy and Nursing, University of Castilla-La Mancha, 45071 Toledo, Spain.

Children (Basel, Switzerland)
|February 26, 2025
PubMed

Insights

Hypoglycemia in preterm infants is linked to abnormal general movements. Early monitoring of blood glucose and movement patterns is crucial for neurodevelopmental outcomes in these vulnerable infants.

Area of Science:

  • Neonatal Medicine
  • Developmental Pediatrics
  • Neuroscience

Background:

  • Moderate-to-late preterm infants are the largest group of premature births globally.
  • This population faces increased risks for neurodevelopmental disorders.
  • Hypoglycemia is a common and significant risk factor in preterm infants.

Purpose of the Study:

  • To investigate the association between hypoglycemia and general movement patterns in early post-term preterm infants.
  • To evaluate the reliability of general movement assessments in this specific infant group.
  • To identify potential neurodevelopmental indicators in preterm infants with hypoglycemia.

Main Methods:

  • Prospective, single-center cohort study of moderate-to-late preterm infants in the NICU.
  • General movements assessed using Prechtl's General Movements Assessment.
  • Blood glucose levels monitored using the FreeStyle Optium™ Neo glucometer; statistical analysis via Fisher's exact test and reliability via ICC and kappa coefficient.

Main Results:

  • 17 preterm infants with hypoglycemia (<45 mg/dL) showed a high prevalence (58.8%) of poor repertoire general movements.
  • Normal general movement patterns were observed in 35.2% of infants with hypoglycemia.
  • Good interobserver reliability (ICC = 0.7) and moderate reliability (kappa = 0.4) were found for movement evaluations.

Conclusions:

  • Transient hypoglycemia in moderate-to-late preterm infants is frequently associated with poor repertoire general movement patterns.
  • Routine monitoring of general movements is a reliable tool for assessing neurodevelopmental status in early post-term preterm infants.
  • These findings underscore the importance of vigilant monitoring for hypoglycemia and associated movement abnormalities in preterm infants.

Keywords:
general movement assessmenthypoglycemiamoderate–late pretermwrithing movements

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