General movement assessment and early motor abnormalities in infants with prenatal toxin and isolated alcohol exposure: A prospective cohort study
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Published on: December 14, 2014
Katharina Jung1, Julia Lenz1, Kathrin Neumayr1
1Department of Pediatric Neurology and Developmental Medicine, iSPZ Hauner MUC, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universität München, Munich, Germany.
Background:
Prenatal substance use, particularly alcohol, adversely affects fetal neurodevelopment. General Movement Assessment (GMA) is a non-invasive method evaluating spontaneous infant motor activity that reflects the integrity of the developing nervous system.
Aims:
To examine whether prenatal toxin exposure, and isolated alcohol exposure specifically, is associated with abnormal early general movements.
Study Design:
Prospective cohort study.
Subjects:
We enrolled 625 infants from February 2022 to December 2024 at neonatal units and a neuropaediatric outpatient clinic at the LMU University Hospital, Munich; 131 had documented prenatal toxin exposure, including 78 exposed to alcohol only.
Outcome Measures:
Quality of general movements was assessed using the Hadders-Algra classification by blinded raters at a mean corrected age of 3.6 weeks (SD 5.9) and, where available, 13.1 weeks (SD 3.9). Odds ratios (ORs) with 95% confidence intervals (CIs) were used to compare the proportions of definitely abnormal recordings between groups.
Results:
At the first assessment (mean corrected age 3.6 weeks, SD 5.9), infants with isolated alcohol exposure showed significantly more definitely abnormal general movements than controls (9.0% vs 3.6%; OR 2.57, 95% CI 1.04-6.37; p = 0.04). In the broader toxin-exposed group, the difference did not reach significance (7.6% vs 3.6%; OR 2.19, 95% CI 0.98-4.86; p = 0.055).
Conclusions:
Isolated prenatal alcohol exposure was associated with abnormal early general movements, supporting GMA as a potential early screening tool. The borderline overall effect and high attrition warrant cautious interpretation and replication.
