Cerebral palsy predictive value of 4 months-AIMS in newborns with hypoxic-ischaemic encephalopathy.

AIM: Predicting motor outcomes in hypoxic-ischaemic encephalopathy (HIE) is challenging. We aimed to assess the value of the four-month Alberta Infant Motor Scale (4M-AIMS) in predicting motor development at 18 months of age.

METHOD: A retrospective cohort study was conducted at Sainte-Justine University Hospital Centre (Canada), including patients with hypoxic-ischemic encephalopathy (HIE) who underwent therapeutic hypothermia between 2009 and 2016. Neurodevelopmental follow-ups were conducted at two and four months with the AIMS, and motor outcomes were classified at 18 months according to the Gross Motor Function Classification System. Ordinal regression was used to assess the predictive value of AIMS scores and brain MRI for motor outcome.

RESULTS

Of the 52 newborns included: 16 children (31 %) had normal motor development, 25 (48 %) displayed motor delays, and 11 patients (21 %) had cerebral palsy. Forty-one (79 %) infants had an abnormal 4M-AIMS score (below the 10th percentile). Early brain MRI and 4M-AIMS scores were both predictive of altered motor outcomes (χ2 = 6.1, p-value = 0.013 and χ2 = 4.9, p-value = 0.029, respectively). A normal four-month AIMS assessment is considered a reliable indicator for excluding a future cerebral palsy.

INTERPRETATION: Complementary assessment with brain MRI and 4M-AIMS with a score below the 0th percentile provides accurate prediction of motor outcomes at 18 months.

SHORT TITLE: Cerebral Palsy predictive value of AIMS.