Related Experiment Videos
Qualitative changes in general movements and their prognostic value in preterm infants
1Faculty of Human Movement Sciences, Free University, Amsterdam, The Netherlands.
Insights
Qualitative movement assessments effectively predict neurological outcomes in preterm infants. This method is more successful than muscle tone exams, especially after 12 weeks corrected age.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Movement analysis
Background:
- Qualitative general movement assessments demonstrate significant predictive power for neurological outcomes in preterm infants with brain damage.
- Preterm infants, particularly those small-for-gestational-age (SGA), require reliable methods for monitoring neurological development.
Purpose of the Study:
- To evaluate the efficacy of qualitative general movement assessments in predicting neurological and mental outcomes in preterm infants.
- To determine the optimal age for assessing general movements for accurate outcome prediction.
Main Methods:
- Qualitative assessments of general movements were conducted in 35 preterm infants (27-34 weeks gestation), including 12 SGA infants.
- Infants were assessed from 35 weeks postmenstrual age through 24 weeks corrected age.
- Neurological and mental outcomes were evaluated at 1 year corrected age.
Main Results:
- Most infants exhibited normal or mildly abnormal movement quality from 35 weeks postmenstrual age through 24 weeks corrected age.
- Seven infants improved from abnormal to normal movement quality, with six showing improvement after 12 weeks corrected age.
- Predictive accuracy for neurological and mental outcomes at 1 year improved significantly after 12 weeks corrected age.
Conclusions:
- Qualitative movement assessments are highly effective in predicting abnormal neurological outcomes in preterm infants.
- These assessments are more successful than traditional methods like muscle tone examinations and elicited responses.
- The predictive value of movement quality assessments increases substantially after 12 weeks corrected age, coinciding with major neural function transformations.
Abstract:
Qualitative assessments of general movements have been shown to have considerable power in predicting neurological outcomes in preterm infants with brain damage. In the present study such assessments were made in 35 preterm infants without major neurological problems before term age, born between 27 and 34 weeks gestation, of whom 12 were small-for-gestational-age (SGA). Most infants maintained a normal or (mildly) abnormal quality from 35 weeks postmenstrual age through 6, 12, 18 to 24 weeks corrected age. Seven changed from initially abnormal movements to a normal quality, six of them after 12 weeks. Differences between SGA and appropriate-for-gestational-age infants became less evident with age, particularly after 12 weeks. This was not the case when comparisons were made on the basis of gestational ages below or above 32 weeks. The prediction of neurological and mental outcomes at 1 year also improved after 12 weeks, around which age a major transformation in neural functions occurs. It is concluded that assessments of movement quality are particularly successful in predicting abnormal outcomes in comparison to examinations based on muscle tone and elicited responses.