General movements and neurodevelopmental outcome at 6 years in extremely preterm born children.

BACKGROUND

Infants born extremely preterm (EPT) face a variety of neurodevelopmental challenges. Those most at risk of adverse outcomes should be detected early.

AIMS

To assess General Movements (GMs) at fidgety age in EPT infants and to investigate whether fidgety movements (FMs) and Motor Optimality Scores - Revised (MOS-R) are associated with neurodevelopmental outcome at six years.

STUDY DESIGN

Longitudinal cohort study.

SUBJECTS

Thirty-eight EPT children (< 28 weeks of gestation, 11 girls).

OUTCOME MEASURES

GMs were assessed from video recordings at three months corrected age using the Prechtl General Movements Assessment and The Motor Optimality Score for 3- to 5-Month-Old Infants - Revised. Neurological (Touwen), cognitive (WPPSI-III) and neuropsychological (NEPSY-II, visuospatial and attention) outcomes were evaluated at six years.

RESULTS

Nine (24 %) of the infants had aberrant (abnormal/sporadic/absent) FMs and all but one had abnormal movement character. Median MOS-R was 21. Infants with aberrant FMs had significantly higher odds ratio (OR) for full-scale intelligence quotient ≤ 85 (FSIQ, OR 7.7, p = 0.03) and auditory attention ≤ -1SD (OR 12.8, p = 0.04). MOS-R scores correlated positively with FSIQ (Spearman r = 0.39, p = 0.02), performance IQ (r = 0.47, p = 0.004), visuospatial processing (Geometric Puzzles, r = 0.53, p = 0.006) and visual attention (r = 0.29, p = 0.01). Overall outcome or neurological outcome did not reach statistical significance in associations with aberrant FMs or MOS-R.

CONCLUSION

Aberrant FMs and lower MOS-R are associated with worse neurodevelopmental outcomes when compared to normal FMs and/or higher MOS-R.