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Published on: November 20, 2015
Cerebral palsy predictive value of 4 months-AIMS in newborns with hypoxic-ischaemic encephalopathy
William Rozalen1, Elana F Pinchefsky2, Jessica Gennaoui3
1Department of Pediatric Neurology, AP-HM Timone Hospital, Marseille, France.
Insights
The four-month Alberta Infant Motor Scale (4M-AIMS) can help predict motor outcomes in infants with hypoxic-ischaemic encephalopathy (HIE). A normal 4M-AIMS score reliably excludes future cerebral palsy.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Neurorehabilitation
Background:
- Predicting motor outcomes in infants with hypoxic-ischaemic encephalopathy (HIE) is clinically challenging.
- Early identification of motor deficits is crucial for timely intervention.
Purpose of the Study:
- To evaluate the predictive value of the four-month Alberta Infant Motor Scale (4M-AIMS) for motor development at 18 months in HIE survivors.
- To assess the role of 4M-AIMS alongside brain MRI in predicting motor outcomes.
Main Methods:
- Retrospective cohort study of 52 HIE infants treated with therapeutic hypothermia.
- Neurodevelopmental assessments using AIMS at 2 and 4 months.
- Motor outcomes classified at 18 months using the Gross Motor Function Classification System.
- Ordinal regression analysis to determine predictive value of AIMS and brain MRI.
Main Results:
- 31% had normal motor development, 48% motor delays, and 21% cerebral palsy at 18 months.
- 79% of infants had abnormal 4M-AIMS scores (below 10th percentile).
- Both early brain MRI and 4M-AIMS scores were significant predictors of altered motor outcomes (p < 0.05).
Conclusions:
- The 4M-AIMS is a valuable tool for predicting motor outcomes in HIE.
- A normal 4M-AIMS assessment at four months is a reliable indicator for excluding cerebral palsy.
- Combined assessment with brain MRI and 4M-AIMS enhances prediction accuracy.
Aim:
Predicting motor outcomes in hypoxic-ischaemic encephalopathy (HIE) is challenging. We aimed to assess the value of the four-month Alberta Infant Motor Scale (4M-AIMS) in predicting motor development at 18 months of age.
Method:
A retrospective cohort study was conducted at Sainte-Justine University Hospital Centre (Canada), including patients with hypoxic-ischemic encephalopathy (HIE) who underwent therapeutic hypothermia between 2009 and 2016. Neurodevelopmental follow-ups were conducted at two and four months with the AIMS, and motor outcomes were classified at 18 months according to the Gross Motor Function Classification System. Ordinal regression was used to assess the predictive value of AIMS scores and brain MRI for motor outcome.
Results:
Of the 52 newborns included: 16 children (31 %) had normal motor development, 25 (48 %) displayed motor delays, and 11 patients (21 %) had cerebral palsy. Forty-one (79 %) infants had an abnormal 4M-AIMS score (below the 10th percentile). Early brain MRI and 4M-AIMS scores were both predictive of altered motor outcomes (χ2 = 6.1, p-value = 0.013 and χ2 = 4.9, p-value = 0.029, respectively). A normal four-month AIMS assessment is considered a reliable indicator for excluding a future cerebral palsy.
Interpretation:
Complementary assessment with brain MRI and 4M-AIMS with a score below the 0th percentile provides accurate prediction of motor outcomes at 18 months.
Short Title:
Cerebral Palsy predictive value of AIMS.
