Can general movements trajectories predict neurodevelopment as early as six months corrected age in very preterm infants?

OBJECTIVE

To evaluate whether prenatal and postnatal clinical variables, General Movements (GMs), and Hammersmith Neurological Examination (HNE) would predict developmental delay. at 6 months corrected age (CA) in preterm infants.

METHODS

Infants born <32 weeks gestational age or <1500 g were enrolled in the first days of life and underwent neurodevelopmental follow-up until 6 months CA. Potential associations between motor, cognitive, and language development assessed by the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) at 6 months CA, and clinical variables, GMs at term equivalent age (TEA) and Fidgety period, HNE at TEA and 3 months CA, were investigated by Mann Whitney U test, chi-square test, Spearman correlation test, multiple logistic regression.

RESULTS

Ninety-eight infants were included. GMs anomalies at TEA predicted an increased risk of motor delay at 6 months CA, regardless of Fidgety quality at 3 months GA (GMs anomalies at TEA and pathological Fidgety, OR 16.05 [95 % CI 1.02-253.50]; GMs anomalies at TEA and normal Fidgety, OR 11.16 [95 % CI 1.18-105.31]). Despite several variables, including GMs, were associated to cognitive and language delay at 6 months CA (p < 0.05), none was found predictive at the multivariate analysis.

CONCLUSIONS

GMs at specific timepoints and GMs trajectories are predictive of early motor delay assessed as early as 6 months CA. Further research is needed to develop standardised protocols for neurodevelopmental longitudinal assessment and to investigate GMs trajectories and their integration with other predictors of neurodevelopment.