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Updated: Aug 4, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Qualitative assessment of general movements in high-risk preterm infants with chronic lung disease requiring
A F Bos1, A Martijn, R M van Asperen
1Department of Pediatrics, Beatrix Children's Hospital, Groningen, The Netherlands.
Insights
Dexamethasone treatment in preterm infants with chronic lung disease transiently reduces spontaneous movement quantity, speed, and amplitude. Abnormal general movements (GMs) correlate with brain lesions and predict cerebral palsy risk.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Neurology
Background:
- Preterm infants with severe chronic lung disease are at high risk for neurodevelopmental impairments.
- General movements (GMs) are sensitive indicators of early neurological development.
- The impact of dexamethasone on spontaneous motor activity in this population requires investigation.
Purpose of the Study:
- To assess the quality of general movements (GMs) in preterm infants at risk for severe chronic lung disease.
- To evaluate the acute effects of dexamethasone treatment on spontaneous motor activity in these infants.
- To explore the relationship between GM quality, brain ultrasonographic findings, and long-term neurodevelopmental outcomes.
Main Methods:
- 15 very low birth weight infants underwent weekly videotape recordings of GMs from preterm to 20 weeks postterm.
- Recordings were taken before and at several time points after initiating dexamethasone therapy.
- Correlation analysis was performed between GM quality, brain ultrasonography, and neurodevelopmental outcomes.
Main Results:
- Dexamethasone therapy significantly reduced the quantity, speed, and amplitude of spontaneous GMs.
- Abnormal GM trajectories were strongly associated with the severity of brain ultrasonographic abnormalities (p < 0.001).
- Cramped-synchronized movements near term and absence of fidgety movements at 3 months predicted cerebral palsy.
Conclusions:
- Dexamethasone treatment acutely reduces motility and alters GM characteristics in preterm infants with chronic lung disease and brain lesions.
- The findings highlight the need for cautious use of systemic dexamethasone in preterm infants due to potential impacts on motor development.
- Further research is needed to understand the long-term neurological sequelae of dexamethasone exposure in this vulnerable population.
Objective:
The objective of this study was to determine in preterm infants at risk for severe chronic lung disease (1) the quality of general movements (GMs) and (2) the effect of dexamethasone treatment on spontaneous motor activity.
Study Design:
In 15 very low birth weight infants the quality of GMs was assessed from repeated videotape recordings. Recordings were made at weekly intervals during the preterm period until term age and thereafter three times until the twentieth postterm week. All infants required dexamethasone therapy, and additional recordings were made a few hours before and 24 hours, 48 hours, and 7 days after dexamethasone was started. The relationship among movement quality, brain ultrasonographic abnormalities, and long-term outcome was explored. Acute effects of dexamethasone on motor activity were examined.
Results:
After dexamethasone therapy was started, a significant transient reduction of the quantity of most spontaneous movements (p < 0.05) and a reduction of speed and amplitude of GMs was found (p < 0.05). A significant relationship was found between the severity of brain ultrasonographic abnormalities and the extent to which developmental trajectories of GMs were abnormal (p < 0.001). The development of cerebral palsy was related to the presence of cramped-synchronized movements near term (p < 0.02) and to the absence of fidgety movements at the age of 3 months after term (p < 0.05).
Conclusion:
In preterm infants with severe chronic lung disease and brain lesions, dexamethasone treatment leads to an acute reduction in motility and changes in the speed and amplitude of GMs. Until more is known about long-term neurologic sequelae, a cautious use of systemic dexamethasone therapy in preterm infants is recommended.
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