Can general movements trajectories predict neurodevelopment as early as six months corrected age in very preterm infants?

Abstract

Objective: To evaluate whether prenatal and postnatal clinical variables, General Movements (GMs), and Hammersmith Neurological Examination (HNE) would predict developmental delay. at 6 months corrected age (CA) in preterm infants.

Methods: Infants born <32 weeks gestational age or <1500 g were enrolled in the first days of life and underwent neurodevelopmental follow-up until 6 months CA. Potential associations between motor, cognitive, and language development assessed by the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) at 6 months CA, and clinical variables, GMs at term equivalent age (TEA) and Fidgety period, HNE at TEA and 3 months CA, were investigated by Mann Whitney U test, chi-square test, Spearman correlation test, multiple logistic regression.

Results: Ninety-eight infants were included. GMs anomalies at TEA predicted an increased risk of motor delay at 6 months CA, regardless of Fidgety quality at 3 months GA (GMs anomalies at TEA and pathological Fidgety, OR 16.05 [95 % CI 1.02-253.50]; GMs anomalies at TEA and normal Fidgety, OR 11.16 [95 % CI 1.18-105.31]). Despite several variables, including GMs, were associated to cognitive and language delay at 6 months CA (p < 0.05), none was found predictive at the multivariate analysis.

Conclusions: GMs at specific timepoints and GMs trajectories are predictive of early motor delay assessed as early as 6 months CA. Further research is needed to develop standardised protocols for neurodevelopmental longitudinal assessment and to investigate GMs trajectories and their integration with other predictors of neurodevelopment.

Keywords: General movements; Neurodevelopmental outcome; Very low birth weight infants; Very preterm infants.