Early visual and spontaneous motor behaviour in very preterm infants: Associations with fidgety movement quality

Early visual and spontaneous motor behaviours develop concurrently during the first months after birth. However, empirical evidence examining their association in very preterm infants remains limited.

To examine associations between early visual and spontaneous motor behaviour in very preterm infants without major brain injury, and to determine whether visual behaviour differs according to fidgety movement quality.

In this cross-sectional study, 84 very preterm infants (<32 weeks gestational age) were assessed at 12-16 weeks corrected age. Visual behaviour was evaluated using the Neonatal Visual Assessment, and spontaneous motor behaviour using the General Movements Assessment and Motor Optimality Score-Revised. Associations were analysed using Spearman correlations with false discovery rate correction. Group differences according to fidgety movement quality were examined using non-parametric tests.

Global visual function was strongly associated with motor optimality (rs = -0.67, p < .001). Domain-specific analyses showed that visual tracking had the strongest associations with movement repertoire (q = 0.004) and movement patterns (q = 0.021), whereas other visual functions showed limited associations. Infants with absent fidgety movements demonstrated the poorest overall visual behaviour, with significant differences compared with both the normal and abnormal fidgety movement groups. They also showed poorer visual tracking than infants with normal fidgety movements.

Early visual and spontaneous motor behaviours are associated in very preterm infants without major brain injury at 12-16 weeks corrected age. Associations were strongest for global measures and visual tracking, suggesting that visual tracking may reflect the concurrent maturation of early visual and motor systems.