Early general movements are associated with developmental outcomes at 4.5–5 years

Abstract

Background: Prechtl's general movements assessment (GMA) post-term has high predictive validity for cerebral palsy, but less is known about whether earlier GMA, including before term, are associated with other developmental problems. Aims: To examine the relationships between GMA prior to term and at term-equivalent, with developmental outcomes at 4.5–5 years' corrected age. Study design: Prospective cohort study. Subjects: 122 very preterm infants born <30 weeks' gestation and 91 healthy term controls. Outcome measures: GMA (categorised as ‘normal’ or ‘abnormal’) were assessed at <32, 32–33 and 34–36 weeks' postmenstrual age for the preterm infants, and at term-equivalent for both groups. Children were assessed at 4.5–5 years' corrected age using the Movement Assessment Battery for Children-2nd edition (MABC-2), Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), Pediatric Quality of Life Inventory (PedsQL), Little Developmental Coordination Disorder Questionnaire (Little DCD-Q) and Wechsler Preschool and Primary Scale of Intelligence-IV (WPPSI-IV). Results: Prior to term, abnormal GMA at the first two timepoints were associated with lower scores on the Little DCD-Q, and abnormal GMA at the second and third timepoints with lower quality of life scores and PEDI-CAT mobility domain scores. Abnormal GMA at term-equivalent were associated with lower MABC-2, mobility and quality of life scores for preterm infants, and worse social/cognitive domain scores for both groups. Conclusions: Abnormal GMA prior to term and at term-equivalent are associated with worse motor, functional and cognitive outcomes at 4.5–5 years' corrected age, and may be useful to identify infants for developmental surveillance/early intervention.