Spontaneous motility in preterm, small-for-gestational age infants. II. Qualitative aspects

Area of Science:

• Neonatal neurology
• Developmental pediatrics
• Fetal medicine

Background:

• Intrauterine growth retardation (IUGR) affects fetal development, potentially leading to long-term neurological deficits.
• Assessing early spontaneous motility, specifically general movements (GMs), offers insights into infant neurological status.
• Preterm infants with low birth weight are at higher risk for developmental abnormalities.

Observation:

• Sequential videotape recordings of 19 preterm infants with IUGR were analyzed for general movements (GMs) quality.
• The study monitored GMs longitudinally from the preterm period up to 20 weeks corrected age.
• Prechtl's method was used for qualitative assessment of GMs.

Findings:

• Abnormal GMs quality was observed in 15 out of 19 (79%) infants with IUGR.
• Abnormal GMs were frequent even in infants with normal brain scans, suggesting GMs are sensitive indicators.
• Abnormal GMs, particularly 'abrupt chaotic' movements, correlated with fetal heart rate decelerations and placental issues.
• Most infants showed normalization of GMs by 3 months postterm, but four did not.
• Fidgety movements quality predicted neurological outcomes at 24 months.

Implications:

• IUGR can induce transient brain dysfunction, detectable through qualitative assessment of GMs.
• Qualitative assessment of GMs is a valuable tool for early identification of neurodevelopmental risks in high-risk infants.
• Monitoring GMs provides a non-invasive method to track neurological development and recovery in infants with IUGR.