Abstract
Background
A neurological assessment before discharge from the NICU would enable early targeted intervention to mitigate the risk and severity of cerebral palsy (CP) and neurodevelopmental disability.
Objective
To assess the accuracy of general movements (GM) in the preterm and fidgety movement periods in predicting neurodevelopmental disability and cerebral palsy in very preterm infants (≤32 weeks gestational age) at 18–24 months corrected gestational age.
Study design
Prospective cohort study
Participants
One hundred and seventy very preterm infants, mean (SD) gestation 29.8 (1.32) weeks, and birthweight 1215 (226) g.
Outcomes
Infants underwent GM assessments in the preterm period (31–36 weeks post-conception age) and fidgety movement period (8–18 weeks post term age). Neurodevelopmental outcomes were assessed in 127 children using the Griffiths Mental Developmental Scales-2.
Results
Nine children had neurodevelopmental disability (two infants with cerebral palsy and seven with global developmental delay. The relative risk (95% CI) for neurodevelopmental disability was 1.46 (0.31–6.89) with preterm movements and 6.07 (0.97–38.05) with fidgety movements. Sensitivity and specificity values for the prediction of neurodevelopmental disability were 33% and 64% in the preterm period and 25% and 92% in the fidgety movement period, respectively. The sensitivity and specificity values for prediction of CP were 50% and 63% in the preterm period and 100% and 93% in the fidgety movement period, respectively.
Conclusion
Preterm movements showed lower sensitivity and specificity than fidgety movements in predicting later CP and neurodevelopmental disability in preterm infants.
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Acknowledgements
Dr Grace Rebekah, for her assistance with statistical analysis, Ms Indira Balan and Ms. Meenakshi Papanasam who helped in organizing follow up appointments for this study, and Mr Selvakumar G for his technical support.
Funding
Funding: Fluid Research Grant of Christian Medical College, Vellore
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Authors and Affiliations
Contributions
Contributors: HB: conceptualized and designed the study, was involved in data collection and analysis, interpretation and conclusion, prepared and revised the manuscript; SPO, RS, LA: involved in study design, supervised data acquisition and analysis, interpretation of data and critical revision of the manuscript; STO: involved in data collection and critical revision of the manuscript. MK: involved in data acquisition and interpretation, guided and critically revised the final manuscript.
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Ethics declarations
Ethics clearance: IEC, Christian Medical College, Vellore; No. 8390, dated Sept 09, 2013.
Competing interests: None stated.
Additional information
Note: Additional material related to this study is available with the online version at https://www.indianpediatrics.net
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John, H.B., Oommen, S.P., Swathi, T.O. et al. Preterm General Movements in Prediction of Neurodevelopmental Disability and Cerebral Palsy at Two Years: A Prospective Cohort Study. Indian Pediatr 59, 769–773 (2022). https://doi.org/10.1007/s13312-022-2619-x
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DOI: https://doi.org/10.1007/s13312-022-2619-x