Preterm and term-equivalent age general movements and 1-year neurodevelopmental outcomes for infants born before 30 weeks' gestation

Abstract

Aim: To examine the associations between Prechtl's General Movements Assessment (GMA), conducted from birth to term-equivalent age, and neurodevelopmental outcomes at 12 months corrected age, in infants born very preterm. Method: One hundred and thirty-seven infants born before 30 weeks' gestation had serial GMA (categorized as ‘normal’ or ‘abnormal’) before term and at term-equivalent age. At 12 months corrected age, neurodevelopment was assessed using the Alberta Infant Motor Scale (AIMS); Neurological, Sensory, Motor, Developmental Assessment (NSMDA); and Touwen Infant Neurological Examination (TINE). The relationships between GMA at four time points and 12-month neurodevelopmental assessments were examined using regression models. Results: Abnormal GMA at all time points were associated with worse continuous scores on the AIMS, NSMDA, and TINE (p<0.05). Abnormal GMA before term and at term-equivalent age were associated with increased odds of mild–severe dysfunction on the NSMDA (odds ratio [OR] 4.26, 95% confidence interval [CI] 1.55–11.71, p<0.01; and OR 4.16, 95% CI 1.55–11.17, p<0.01 respectively) and abnormal GMA before term with increased odds of suboptimal–abnormal motor function on the TINE (OR 2.75, 95% CI 1.10–6.85, p=0.03). Interpretation: Abnormal GMA before term and at term-equivalent age were associated with worse neurodevelopment at 12 months corrected age in children born very preterm. What this paper adds: Abnormal general movements before term predict developmental deficits at 1 year in infants born very preterm. General Movements Assessment before term identifies at-risk infants born very preterm.