General movements in very preterm children and neurodevelopment at 2 and 4 years

Alicia J. Spittle, Megan M. Spencer-Smith, Jeanie L Y Cheong, Abbey L. Eeles, Katherine J. Lee, Peter J. Anderson, Lex W. Doyle

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114 Citations (Scopus)

Abstract

OBJECTIVE: Although ~50% of very preterm (VP) children have neurodevelopmental impairments, early prediction of infants who will experience problems later in life remains a challenge. This study evaluated the predictive value of general movements (GM; spontaneous and endogenous movements) at 1 and 3 months' corrected age for neurodevelopment at 2 and 4 years of age in VP children. METHODS: At 1 and 3 months' corrected age, infants born ,30 weeks' gestation had GM assessed as normal or abnormal. Motor, cognitive, and language development at 2 years was assessed by using the Bayley Scales of Infant and Toddler Development, Third Edition. At 4 years, cognitive and language outcomes were assessed by using the Differential Ability Scale-Second Edition and motor outcomes with the Movement Assessment Battery for Children-Second Edition; a diagnosis of cerebral palsy was documented. RESULTS: Ninety-nine VP infants were recruited, with 97% and 88% of survivors followed up at age 2 and 4 years, respectively. Abnormal GM at 1 month were associated with worse motor outcomes at 2 and 4 years but not language or cognitive outcomes. Abnormal GM at 3 months were associated with worse motor, cognitive, and language outcomes at both 2 and 4 years. Overall, GM at 1 month demonstrated better sensitivity to impairments at 2 and 4 years, whereas GM at 3 months had better specificity and were more accurate overall at distinguishing between children with and without impairment. CONCLUSIONS: Abnormal GM in VP infants, particularly at 3 months postterm, are predictive of worse neurodevelopment at ages 2 and 4 years.

Original languageEnglish
Article numbere452-8
Pages (from-to)1-9
Number of pages9
JournalPediatrics
Volume132
Issue number2
DOIs
Publication statusPublished - Aug 2013
Externally publishedYes

Keywords

  • General movements assessment
  • Neurodevelopmental outcome
  • Preterm infant

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