Related Experiment Videos
The influence of septicaemia on spontaneous motility in preterm infants
A F Bos1, R M van Asperen, D M de Leeuw
1Dept. of Paediatrics, Division of Neonatology, Beatrix Children's Hospital, University Hospital, Groningen, The Netherlands. a.f.bos@med.rug.nl
Insights
Systemic infections in preterm infants cause transiently sluggish general movements (GMs), not the abnormal GMs seen with brain lesions. GM quality, including speed and amplitude, normalized post-infection.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Infectious diseases
Background:
- Qualitative assessment of general movements (GMs) is crucial for evaluating central nervous system integrity in preterm infants.
- Distinguishing between GMs affected by brain lesions and those affected by systemic infections is clinically important.
Purpose of the Study:
- To investigate the impact of severe systemic infections (septicemia) on the quality of general movements in preterm infants.
- To determine if systemic infections cause abnormal GMs similar to brain lesions.
Main Methods:
- Sequential video-recordings of general movements (GMs) in six preterm infants with initially normal GMs.
- Recordings were analyzed during the acute phase of proven septicemia (Candida albicans, Staphylococcus aureus).
- Comparison of GM quality before, during, and after the septicemic episode.
Main Results:
- Five of six infants maintained largely intact GM complexity and variability during septicemia.
- One infant showed transiently abnormal GMs.
- GM speed and amplitude were diminished during septicemia, resulting in a sluggish appearance.
- GM quality normalized within 1-2 weeks after the septicemia resolved.
Conclusions:
- Sluggish GMs during severe systemic infections can be differentiated from abnormal GMs caused by cerebral lesions by considering GM complexity.
- General movements assessment remains a valuable tool for monitoring preterm infant neurodevelopmental status during and after infections.
Abstract:
The qualitative assessment of general movements (GMs) in preterm infants is a sensitive method to investigate the integrity of the central nervous system. The question arises whether systemic infections affect the quality of GMs in a similar fashion to brain lesions. We were able to provide an answer to this problem in six infants (gestational age 24.4-32.4 weeks, birth weight 600-1660 grams), who had initially normal GMs as analyzed from sequential video-recordings. All infants sustained a proven septicaemia (Candida albicans in two, Staphylococcus aureus in three, a coagulase-negative staphylococcus in one infant). Unintentionally, recordings were also made during the acute phase. The complexity and variability of the GMs remained largely intact in five of the six infants; only one infant had transiently abnormal GMs. Compared with 1 week before the acute phase, the speed and amplitude of the GMs were diminished, giving the GMs a sluggish appearance. One to two weeks after the acute phase of septicaemia, the quality of GMs, i.e. speed and amplitude, had normalized in all infants. This study demonstrates that it is possible to discriminate between abnormal GMs due to cerebral lesions and sluggish GMs due to severe systemic infections, when the complexity of the GMs is considered as the main characteristic for judgement of normality of GM-quality.